HEALTH 
AND»EFFICIENCY 




Book y\ i z 

CoipgM? 



COHRIGHT DEPOSJt 




EFFICIENCY 



HEALTH 
AND EFFICIENCY 



BY 



JOHN DALY McCARTHY, M.A., Ph.D. 

/;/ Charge, of Hygiene, De Witt Clinton High School, 
New York City 




New York 


HENRY HOLT AND COMPANY 


1922 




Copyright, 1922 

BV 

HENRY HOLT AND COMPANY 



PRINTED IN THE U. S. A. 



JAN 1 9 1922 
©CU6-54318 



nA-l I 



" 



DEDICATED 

TO THE BEST AND WISEST 

OF ALL MY TEACHERS 

MY 

FATHER AND MOTHER 



PREFACE 

This book has been written for boys and girls in 
the Junior and Senior High Schools. It aims to pre- 
sent the fundamental principles of Hygiene and San- 
itation in such a way as to lead to better health and 
greater efficiency. Only sufficient Anatomy and Phys- 
iology has been included to form a suitable background 
for the study of the principles of good living. From 
an experience of over ten years with High School 
pupils the author is convinced that too much emphasis 
has been laid on a technical study of body structure 
and function and too little on the care of the body. 
The author believes furthermore that the study of the 
care of the body is of much more consequence to the 
High School girl and boy than is a detailed study of 
its composition. Many teachers attempt problems in 
Anatomy and Physiology with Secondary School pupils 
which College and University students find difficult. 

The author acknowledges with appreciation the as- 
sistance given by the New York City Department of 
Health; the Massachusetts State Board of Health; 
the American Posture League ; and the U. S. Hygienic 
Laboratory. To Dr. John L. Tildsley, Associate Su- 
perintendent in charge of High Schools and Training 
Schools, New York City, the author is indebted for a 



vi PREFACE 

large share of the interest which he has in educational 
problems generally and for constant guidance and help- 
fulness. The outline followed in writing the book is 
one which was used at the DeWitt Clinton High 
School, New York City, by the Department of Hy- 
giene. It was completed only by the cooperation of the 
teachers of Hygiene in that school and by the very 
friendly helpfulness of the Principal, Dr. Francis H. 
J. Paul. The Department of Hygiene in the DeWitt 
Clinton High School is an outgrowth of the Depart- 
ment of Biology of that school of which Dr. Geo. W. 
Hunter, now Professor of Biology in Knox College, 
was formerly Chairman. Dr. Hunter was one of the 
pioneers in the teaching of Biology and Hygiene in this 
country and the author is indebted to him for many 
valuable suggestions. In conclusion the author extends 
his warmest thanks to his wife who has provided 
constant encouragement and helpful direction to the 
enterprise. 

John Daly McCarthy. 



CONTENTS 

PART I— PERSONAL HYGIENE 

CHAPTER PAGE 

I General structure of the human body . 3 

II Man and disease 16 

III Posture and exercise 39 

IV Air and breathing 57 

V Food and diet 72 

VI The care of the mouth, nose, throat and 

ORGANS OF SPEECH IO9 

VII Digestion, absorption, circulation, and 

THE HYGIENE OF THE ALIMENTARY CANAL . 120 

VIII The hygiene of the skin and the use of 

CLOTHING 135 

IX The organs of sense 145 

X Mental hygiene 155 

XI First aid 168 

PART II— SCHOOL AND HOME HYGIENE 

XII School hygiene 179 

XIII Hygiene of the home ...,,,, 185 

vii 



viii CONTENTS 

PART III— COMMUNITY HYGIENE 

CHAPTER PAGE 

XIV Food distribution 199 

XV Disposition of wastes 222 

XVI Some animal enemies of man .... 226 

XVII Community control of disease . . . . 240 

XVIII Industrial hygiene 247 

Index 261 



PART I 
PERSONAL HYGIENE 



CHAPTER I 

THE GENERAL STRUCTURE OF THE 
HUMAN BODY 

i. Introduction. Man's knowledge of his own body 
has always been less than his knowledge of vehicles 
of travel, of habitations, and of machinery. The 
struggle for existence, the desire for gold, for travel* 
and for luxury seem always to have been greater than 
the desire to know the secrets of the human body, the 
seat of intellect. In fact, at different times, such 
study of the human body by means of dissection has 
been forbidden even by some of our own state laws. 
In view of this prejudice, it is not surprising that men 
are so little acquainted with their own physical struc- 
ture, even though a knowledge of the structure of 
the human body is fundamental to a knowledge of 
medicine, of hygiene, of sanitation, and in general, 
to a knowledge of healthy living and human efficiency. 
The wave of feeling against the use of alcohol has 
been due, in large part, to a knowledge of what alco- 
hol does to the body after its absorption. Instead of 
the orgies, so common in the past, when men loaded 
their bodies with food and drink, we find to-day more 
and more persons restricting their consumption of 
beverages and food with a view to making themselves 

3 



4 HEALTH AND EFFICIENCY 

as efficient as the machines which their minds have 
devised. 

We owe the astounding advances in medicine to a 
study of the structure of the human body. In olden 
times it was sometimes even held that disease was 
due to evil spirits. Fortunately, however, here and 
there, inquiring and observing men, by applying them- 
selves to a practical study of the human structure 
gained an immense amount of information about it. 
We are especially indebted to the Italian scientists, 
who, many years ago, established centers of inquiry 
for the pursuit of this study. At the great and 
famous University of Bologna, very skillful dissec- 
tions were made as early as the thirteenth century and 
one of the records of these was a standard text for 
several hundred years. The traditions thus estab- 
lished finally bore fruit in the great discovery of Pas- 
teur that minute organisms are very frequently the 
cause of disease. 

While men vary in their racial origins, their envir- 
onment, customs, and tastes, the same fundamental 
physical structure is a heritage of all. Whether we 
regard the Scriptural account of the origin of man 
as indicating that he was formed in a very short per- 
iod of time, or whether, with Augustine, we regard 
the body as the product of ages of development from 
lower forms of life, we must all agree that it is a 
marvelous structure. So wonderfully perfect is it in 
its workings that the Psalmist was led to cry out, " I 
will praise Thee, O Lord ; for I am fearfully and won- 
derfully made." 




Fig. 1. — A front view of an adult human skeleton to illustrate 
the mode in which the bones are connected at the joints. 

a Ligaments of the Elbow Joint; b The Ligament which is con- 
nected with the ventral surfaces of the bodies of the Vertebrae; 
■e Ligament connecting the Pelvis to the Spine; / Ligament con-, 
necting the Pelvis to the Sacrum; g The Ligaments of the Wrist 
Joint; h The Membrane which fills up the interval between the 
two bones of the Forearm; / A similar Membrane between the 
two bones of the Leg, and, lower down, /, ligaments of the Ankle 
Joint; n Ligaments of the Knee Joint; oo Ligaments of the Toes 
and Fingers; p Capsular Ligament of the Hip Joint; q Capsular 
Ligament of the Shoulder Joint. 



6 HEALTH AND EFFICIENCY 

2. The bony framework and the muscles. Much 
of our knowledge of the structure of the human body 
has been gained by first studying the lower animals, 
both living and dead. The body of a cat or of a fish, 
for instance, resembles in several ways the human 
body. Each contains a bony framework which gives 
it form and strength. This is not present in a worm 
or a jelly fish, and if it were not present in the human 
body locomotion would be difficult and many of the 
more delicate arts like painting, construction, and writ- 
ing would be impossible. There are about two hun- 
dred bones in the human body — varying in size from 
the tiny bones of the ear to the huge thigh bone of the 
leg. Reference to Fig. i shows that the skeleton is 
made up, in general, of the skull (the bony framework 
of the head), the spinal column (backbone), the bones 
of the shoulders, the bones of the hips, the ribs, and 
those of the appendages (arms and legs). The skull 
and spinal column surround and protect the central 
part of the nervous system — the brain and spinal 
cord. The backbone is made up of many small parts 
called vertebrae. The tips of these vertebrae can be 
felt by running the fingers along the backbone in the 
living human body. The spinal column, when seen 
from the side, forms a curve similar to that in an elon- 
gated S. This arrangement of the vertebrae is one of 
the most marvelous adaptations found in Nature. It 
adds grace to the body, affords protection to some of 
the organs of the abdomen, and hinders the transmis- 
sion of shocks from the feet to the head. It should be 
noted here that although the spine shows a curve when 



GENERAL STRUCTURE HUMAN BODY 7 

examined from the side, it forms a straight line ill the 
normal body when seen from behind. The bones of the 
spinal column, as well as most other bones in the body, 
act as attachments for muscles. Thus one can feel 
on each side of the nape of the neck two thick, short 
muscles running from the base of the skull to the 
upper part of the spinal column. When these con- 
tract, the head is pulled backward. It is as if a thick 
rubber band were stretched from the rear of the skull 
to the top of the backbone and attached at these two 
points. One can easily see that the result would be 
to bend the head backward. Similarly, two other sets 
of muscles run along the front part of the backbone 
and pull the head forward. Consequently, when the 
pull of the two sets of muscles — front and back — is 
equal, the head is in such a position that the eyes look 
straight forward. A similar pairing of muscles is 
seen in the upper arm where the pull of the muscle on 
the front of the arm doubles the arm, while the pull 
of the muscle on the back of the arm straightens it 
out. Besides serving as attachments for muscles, the 
bones often protect delicate parts in the interior of 
the body, as for example the bones of the skull pro- 
tect the brain, and the rib bones protect the lungs and 
heart. 

Some of the bones, for instance those of the upper 
arm and of the leg, are hollow, thereby decreasing the 
weight of the body and adding to the ability of the 
skeleton to support it in an upright position. Engin- 
eers have borrowed this principle from Nature, and 
made supporting iron pillars for bridges, etc., hollow. 



HEALTH AND EFFICIENCY 



It has been discovered in recent years that the soft, red- 
dish substance often seen in soup bones and called 



Jiiver 



JiQryt intestine 




Jippendi% 
prnall intestine. 

Fig. 2. — The digestive system 
" marrow " is the source of a very important part of the 
blood. In fact several diseases of the blood seem to 
have their origin in disturbances of the bone marrow. 



GENERAL STRUCTURE HUMAN BODY 9 

3. The digestive canal is a coiled tube, nearly thirty 
feet in length, which runs through the body. Refer- 
ence to Fig. 2 shows that it begins with the mouth 
and •runs through the neck to the stomach. After 
leaving this organ, it coils from side to side across the 
abdomen, finally expanding and ending as the large 
intestine. The part between the stomach and the large 
intestine is the small intestine and is about 22 feet 
in length. Near the stomach, connected with the small 
intestine by means of ducts or canals, is the large, 
three lobed, reddish brown liver and the small, yellow- 
ish pancreas, both of which secrete into the intestine 
very important fluids which digest our food. At the 
point where the small intestine passes into the large in- 
testine is a finger-like projection about two or three 
inches long. This is the appendix. Inflammation of 
this organ is frequently accompanied by pain in the 
lower right part of the abdomen. The intestine occu- 
pies a large part of the abdomen*. In cases of overeat- 
ing and as a result of certain diseases, huge masses of 
fat are deposited between the coils of the intestine, 
producing a protruding abdomen, one of the most hid- 
eous deformities of the body. 

Demonstrate to the class the general position of your 
own stomach, liver, small intestine, large intestine, and 
appendix. 

4. The heart and blood channels. If you put the 
palm of the hand on the left side of the chest in the 
region of the fifth or sixth rib, you will feel a firm tap 
at least every second. This is produced by the heart, 
a large muscular organ about the size of the fist, which 



10 



HEALTH AND EFFICIENCY 



contracts and relaxes with pronounced regularity. 
The heart keeps up its work from birth until death — 



Arteries to 
head, arm and Deck 

Puhno'naru vem~TJ] 



Left auricle, 
Aoria 
Left ventricle. 



Artenes to 
lover part of Tj 
bockj 

0tomach and 
intestine 



Capillaries 




Vein s from head 
arm and neck 



rnonaru 
arteru 

R19M auricle 
Riaht ventricle 



Vein from 
intestine to liver 
Wj (Ported vein) 
7/ 

•jArterij to liver 
Tissue cells 



Fig. 3. — Diagram of the circulation 
the left ventricle pumping blood into the arteries 
which carry it to the most remote parts of the body, 
from where it flows back by way of the veins to the 



GENERAL STRUCTURE HUMAN BODY 11 

right auricle to be pumped into the right ventricle. 
The right ventricle pumps the blood into the pulmonary 
artery which carries it to the lungs, from where it 
passes into the pulmonary vein to be carried to the 
left auricle and thence to the left ventricle. The left 
ventricle has the strongest walls of any of the four 
chambers because of the great amount of w r ork it has 
to do. The four chambers do not work independently 
but the two auricles contract first, followed a fraction 
of a second later by a contraction of the ventricles. 
From the fact that the beat of the heart is felt most 
distinctly on the left side of the body most persons 
give that as its location, but, as a matter of fact, it is lo- 
cated about in the middle of the chest, between the two 
lungs. The best way to study the heart is to get a beef 
heart at the butcher's and to cut it open. It will be 
found to contain four chambers, two upper, the auri- 
cles, and two lower, the ventricles. Connected with 
these are muscular tubes, which, when the heart is in 
its proper place, lead to, or from, various parts of the 
body. The tubes are the blood vessels and are classi- 
fied as veins and arteries. If they carry blood to the 
heart they are called veins and if they carry blood away 
from the heart they are called arteries. Through them 
and through the heart the blood circulates in life in a 
never ending stream, the heart with each contraction 
pumping blood to the head, to the organs of the abdo- 
men, and to the extremities, and then drawing it back 
again. The entire time taken for a drop of blood to 
make a complete circuit of the body is about thirty 



12 



HEALTH AND EFFICIENCY 



seconds. When one remembers that about one-thir- 
teenth of the weight of the body is blood and that the 
entire amount is kept in constant, rapid circulation, 



Vein bringing blood 
to the heart from 
the upper parts 
of the body- 



Right auricle 



Large artery carrying 
blood to all parts of 
the body except 
the lungs 



Artery which 
carrys blood to 
the lungs 



Wall of 




right auricle \k^. 



Valve 



Wall of right 
ventricle 



Valve 



Vein bringing blood 
to the heart from the 
lower parts of the body 



Left ventricle 



Fig. 4.— Showing the interior of the right side of the 

heart 

he gets a good idea of the amount of work placed on 
the heart. 

5. The organs of breathing consist mainly of the 



GENERAL STRUCTURE HUMAN BODY 13 



two lungs, which lie within the chest walls. The air 
comes through the mouth or nose and thence down the 
windpipe or trachea to the lungs. Just before the 
trachea reaches the lungs it subdivides into two short 
branches, the bronchi, one of which goes toward the 
right side of the chest, to connect with the right lung; 
the other toward the left to connect with the left lung. 




Fig. 5. — The breathing system 
Upon entering the lungs, the bronchi at once multiply 
into an immense number of smaller branches, the 
bronchial tubes, which in turn divide into smaller ones 
and thus penetrate to every part of the lungs. The 
bronchial tubes have very thin walls and each one 
leads to numerous rounded spaces called air sacs. Sur- 
rounding each air sac is a meshwork of tiny blood 



14 HEALTH AND EFFICIENCY 

vessels. It is estimated that if this meshwork of blood 
vessels surrounding the air sacs in the two lungs could 
be patched together, it would cover an area of 800 
square feet. 

Surrounding each lung is a sheet of thin membrane 
called the pleura. Sometimes the pleura becomes in- 
flamed and a disease called pleurisy is produced. 

6. The brain and other parts of the nervous sys- 
tem. The brain, through which the mind acts, is so 
complex, both in its structure and function, that it is 
impossible to thoroughly comprehend the problems 
which it presents. The brain of a normal male adult 
Anglo-Saxon averages about three pounds, although 
tlie weight may vary from this figure by as much as a 
pound, and the person be perfectly normal. The hu- 
man brain is surrounded and protected by the bones 
of the skull. Although it is provided with few blood 
vessels in proportion to the work that it does, yet one- 
fifth of the entire blood supply of the body goes to it. 
It consists of three main parts called respectively the 
fore, mid, and hind brain. It is to be noted that the fore 
brain is the largest of these, and that it is divided into 
right and left halves, called hemispheres. The brain is 
not only the seat of thought but it contains centers 
connected with the organs of seeing, hearing, smelling, 
efc. So important is the function of these centers that 
it has been said, " A person does not have a musical 
ear, he has a musical brain. " 

A great economy of energy is shown by the brain. 
Thus the entire brain does not supervise hearing or 
seeing or thinking, but separate areas are set apart 



GENERAL STRUCTURE HUMAN BODY 15 

for each of these functions. Consequently, if a tumor 
grows on one portion of the brain, the sense of sight 
is interfered with; if it grows on another portion of 
the brain, the sense of hearing is interfered with, and 
so on. 

The brain is in contact with the eye, the ear, the nose, 
etc., by means of lines of communication called nerves. 
From the hind brain, the spinal cord runs down through 
the spinal column, giving out branches through the 
spaces between the vertebrae, and finally completely 
branching in the region of the small of the back. The 
branches, or nerves, run to the lungs, heart, stomach, 
muscles, and other organs. The beating of the heart, 
the digestion of food, and the action of the muscles are 
all regulated by impulses sent from the brain, or cord, 
along the nerves. Vice versa, it is by impulses sent 
from the skin, eyes and ears along the nerves to the 
cord and brain that we feel, see, and hear. 



CHAPTER II 
MAN AND DISEASE 

7. Early conceptions of disease. The ideas of prim- 
itive man in regard to disease were clothed in mystery. 
Disease was sometimes thought to be due to evil spirits 
taking possession of the body. It was then combated 
by prayer to the good spirits or to the gods of the tribe. 
In America, each Indian tribe had its Medicine Man, 
an individual chosen with care and surrounded with 
considerable dignity. In cases of epidemics, the Med- 
icine Man was called upon to cast out the evil spirits 
which brought disease. Among more advanced peo- 
ples, such as the early Greeks and Romans, disease 
was thought to be due to a disturbance in the relative 
amounts of " humors," or fluids, circulating about the 
body. The conceptions of the Hebrews seem to have 
been more definite, for Moses drew up for that people 
an excellent set of laws pertaining to diet, living condi- 
tions, and the disposition of wastes. 

8. The discoveries of Pasteur. Only recently, how- 
ever, have we known very definitely the cause of dis- 
ease. The man who made this great discovery was 
Louis Pasteur, a French scientist, who died in 1895. 
Pasteur was a chemist whose attention was attracted 
to the subject of disease by an epidemic which spread 
among the silk worms in France during the year 1865. 

16 



MAN AND DISEASE 



17 



In the south of France, the manufacture of silk is a 
very important industry, thousands of persons depend- 
ing on it for a livelihood. Silk is made by a caterpillar 
which lives on the leaves of the mulberry and other 




Copyright, Underwood & Underwood 

Fig. 6. — Pasteur 
trees and which will, if undisturbed, weave about itself 
a cocoon of white silk in which it will remain for sev- 
eral weeks or months and then come forth as a beauti- 
ful moth. The cocoons of at least two species of silk 
worms can be found in this country, but the silk is not 



18 HEALTH AND EFFICIENCY 

of a high enough grade to warrant the development of 
an industry. The silk made by the silk worms of 
France brings to that country a revenue running up 
into millions of dollars. In the year 1865 the silk 
worms were attacked by an unknown disease which 
killed them before they were able to build cocoons. 
The silk owners and the Government were aroused. 
Experts in the raising of silk worms were sent for. 
Scientists were summoned from their laboratories. 
But all in vain ! Not one of them could stop the epi- 
demic. Finally Pasteur was summoned. He protested 
that he had no knowledge of silk worms and could be of 
no service. But he was implored to study the silk 
worm sickness for even a short time. His work was 
rewarded by the discovery in the bodies of the sick 
worms, of tiny creatures which he later proved to be 
the cause of sickness. He was then able to show the 
silk growers a remedy for the disease. 

In this manner Pasteur became the founder of the 
very important science of Germ-life or Bacteriology. 
He extended his studies and made important discoveries 
in regard to cholera and pneumonia. Later still, be- 
coming interested in the terrible sufferings of children 
who had been bitten by dogs or cats and who had in 
consequence developed rabies or hydrophobia, Pasteur 
was able to prove that the disease was spread through 
the saliva of the dog or cat. Although he was not 
able to find the germ causing this disease, he discovered 
a way to save thousands of lives through a treatment 
of rabies. 

9. What are germs? Most persons will reply to 



MAN AND DISEASE 



19 



this question, " Why, they are microbes. " And if they 
are asked, " What are microbes ? " they will either say 
that they are germs or that they do not know. Why 
is it we talk so much about germs and yet know so lit- 
tle about them? The reason is that we know them 





1 -. 

'■ 18 ■ 

11 ! , 



Fig. 7. — Tubes of nutrient material used for growing 
bacteria. The whitish deposits on the surface 
represent colonies of bacteria 

chiefly by their effects. They are so small that only 
the largest can be seen .with our best microscopes. 
Some are therefore so small that no one has ever seen 
them. Here again we know them only by their effects. 
What are their effects? Among other things they de- 
cay food ; they cause disease ; they sour milk ; they tan 



20 HEALTH AND EFFICIENCY 

leather; they make possible the flax and hemp indus- 
tries ; and they give flavor to cheese and cream. Germs 
are, in consequence, the friends and foes of man. 
Some varieties are scrupulously avoided because they 
produce horrible epidemics of disease ; other varieties 
are carefully cultivated and eaten with food because 
they are said to improve digestion and assimilation. 
An example of the former variety is the germ which 
causes the influenza and which has been the cause of 
awful plagues and pestilences of the past; an ex- 
ample of the latter is the germ in sour milk, butter- 
milk, and their commercialized products, Fermillac, 
Zoolac, etc. Some germs are animals ; others are plants. 
Malaria is caused by a tiny one-celled animal which 
looks like an amoeba. Tuberculosis, on the other hand, 
is caused by a one-celled plant. Germs were first ob- 
served in 1650 by a Jesuit priest — Kircher. Plant 
germs belong to that division of the plant kingdom 
called bacteria. Ask your teacher to show you some 
Bulgarian bacteria under the microscope. They can 
be bought at the drug stores in compressed masses and 
then grown in milk. A drop of the milk can then be 
stained with a dye and the bacteria will stand out dis- 
tinctly. Men who tend horses or cattle sometimes con- 
tract a dreaded disease called anthrax, the germ get- 
ting into the system through a cut or a pimple. A case 
occurred in New York recently, where a man probably 
contracted it by getting a sliver into his hand from a 
hitching post. Can you trace the course that the germ 
took in this case? Other cases are on record of men 



MAN AND DISEASE 21 

contracting it through the handling of hides, leather, 
furs, or even the use of a shaving brush. 

If you have examined the Bulgarian bacteria under 
the microscope you have found them to be about one- 
eighth of an inch long. But your microscope magnified 




Photograph from Underwood & Underwood 

Fig. 8. — Metchnikof, a noted Russian physiologist, suc- 
cessor to Pasteur as director of the Pasteur 
Institute, Paris 

them how much ? What was their actual length, there- 
fore? So you see that bacteria are extremely small. 
They are very different from most plants that you 
have seen because they are so very tiny and are not 
green. Bacteria have very curious shapes. In fact, 
they do not look like living things; but those who 



22 



HEALTH AND EFFICIENCY 



have been so unfortunate as to have harbored the 
bacteria of diphtheria or influenza know that they are 
very much alive. They are very simple in structure, 
being composed of only one cell. If you examine 
with a microscope a thin section of another plant with 
which you are familiar, for instance a portion of the 




Photograph from Underwood & Underwood 

Fig. 9- — Charles Darwin, the great English biologist ; 
founder of the " Darwinian " theory of evolution 

leaf of a lily, you notice that it is composed of many 
tiny structures called cells. These are held together by 
cell walls, which surround the cells and which are more 
or less continuous. The cell wall encloses a mass of 
slimy material somewhat like the white of a raw egg f 
called living matter or protoplasm. The protoplasm, 
in turn, usually contains, near its center, a rounded 



MAN AND DISEASE 23 

mass of denser protoplasm, which is called a nucleus. 
Most of the plants with which we are familiar are 
very complicated in structure, but not so with bacteria. 
They are apparently as simple as they are tiny. Each 
bacterium consists mainly of a minute mass of proto- 
plasm enclosed by a cell wall of cellulose. Some have 
tiny whip-like projections from their bodies by means 
of which they swim about in liquids. They swarm al- 
most everywhere but are particularly abundant in filth, 
decaying flesh, and in stagnant water. They increase 
in number at an incredible rate; when a bacterium 
reaches a certain size it simply divides into two bac- 
teria. Since the bacteria grow very fast when they 
receive plenty of food and since they sometimes divide 
as often as once in twenty minutes, millions may be 
formed in a day. Take a pencil and paper and figure 
it out for yourself. 

10. How do we know that germs may produce 
disease? As was indicated in the first part of this 
chapter, it took man a long time to learn that disease 
may be caused by germs. Indeed there are some edu- 
cated people to-day who do not believe it. In view of 
this, it would be well to examine into the reasons for 
believing in one of the greatest discoveries of all time 
— the Germ Theory of Disease. In the first place, it 
is well to note that the leaders in the study of this field 
have all been hard-headed scientists — such men as Pas- 
teur, Koch, and Lister — men to whom only seeing is 
believing. Pasteur said, " In experimental science, it is 
always a mistake not to doubt when facts do not compel 
affirmation." So much of a doubter was Koch that 



24 



HEALTH AND EFFICIENCY 



he lay down four tests, or postulates, as he called them, 
which an investigator must satisfy if he wishes to con- 
vince others that he has discovered the germ causing a 
certain disease. First, Koch said, the investigator must 
show that the germ described is invariably found in the 
diseased part — in the case of ordinary tuberculosis 
it would be the lung : Secondly, he must grow the germ 
in pure culture ; that is, he must cause it to grow out- 
side the body on some culture substance like gelatin or 




Fig. 10. — A modern method of treating tuberculosis 

albumen and unmixed with any other form of germ: 
Thirdly, this germ, w T hen injected into the body of an 
animal like a rabbit or guinea pig, must produce the 
disease under consideration : Fourthly, the germ must 
be recovered from the diseased part of the sick animal. 
When medical science, therefore, assures us that the 



MAN AND DISEASE 



25 



cause of a certain disease has been found, we may un- 
derstand that the case has been subjected to a most 
searching and critical examination. 

ii. Action of germs in the body. It is almost in- 
comprehensible that such tiny and simple creatures as 
germs could produce horrible diseases and even death. 
Yet such is the case. How do they do it? Well, for 
instance, the germ causing tuberculosis produces dis- 
ease by slowly consuming the lungs or other 
parts of the body. This germ, therefore, which is so 



^BHffff -''' * ! 




" — tT^^w^^- -^ 






\ " 1K5S 




^^ 1 



Copyright, Underwood & Underwood 

Fig. ii. — " Muffled faces " — to halt the influenza epidemic 

small that it is difficult to find it even with a high-pow- 
ered microscope, is capable of causing conditions which 
produce the sweats, fever, and shrunken bodies of 
tubercular people. Other diseases, as for instance 
diphtheria, are produced by germs which secrete poisons 
or toxins. These toxins are carried by the blood stream 
all over the body, affecting certain tissues or organs and 
thus producing the symptoms characteristic of the dis- 
ease. Since the body frequently offers a favorable 



26 HEALTH AND EFFICIENCY 

condition for the growth and multiplication of bacteria, 
a few finding lodgment may cause untold harm in a 
short time. 

12. How do germs spread from one person to an- 
other? — The influenza epidemic, which played such 
havoc throughout the world, started in Russia, swept 
through the Scandinavian countries, then went into 
England, Germany, France, Spain, and finally reached 
America. How was it carried? If we knew the germ 
that causes influenza it would be much easier to answer 
this question. But from its general nature and from 
its resemblance to other diseases, as for instance 
grippe, medical authorities believe that it was spread 
largely by means of the discharges from human bodies, 
principally by coughing, sneezing, or talking with effort 
close to another person, When a person sneezes or 
coughs into the air tiny droplets of moisture pass from 
his mouth in the form of a fine spray as you have prob- 
ably noticed. These droplets of moisture remain sus- 
pended in the air, perhaps for some time. They are 
very apt to contain germs gathered from the person's 
mouth, nose, and throat and may consequently spread 
such diseases as colds, grippe, and influenza. For this 
reason no intelligent person coughs or sneezes into the 
air. A handkerchief should always be put over the 
mouth and nose to catch their discharges. The influ- 
enza epidemic may have been spread also by hand- 
shaking, kissing, and by the use of common towels and 
drinking cups. Since communicable diseases, that is 
to say diseases which may be carried from one person 
to another, are caused by germs, any object coming in 



MAN AND DISEASE 



27 



contact with a diseased person may transmit the sick- 
ness. Thus lead-pencils, drinking and eating utensils, 
straps on trolley cars, door knobs, etc., may convey the 
germs causing disease. For this reason the face, hands, 
and neck should be washed as soon as a pupil reaches 
home. It should be remembered, however, that such 
objects as some of those first mentioned would furnish 
no food for the germs and that the latter would conse- 
quently die in a short time if left upon them. How- 




Fig. 12. — Properly cleaned utensils to be used in handling 

milk 

ever, common towels, door knobs, and car straps are in 
constant use and new deposits of germs are being made 
constantly. 

Some very severe diseases such as typhoid fever, 
tuberculosis, and scarlet fever may be transmitted by 
using food containing them. Before public health edu- 
cation was as well developed as it is now, typhoid epi- 
demics were altogether too frequently brought about 



28 HEALTH AND EFFICIENCY 

by using water or milk infected by typhoid bacteria. 
While more care is taken with milk and water to-day, 
not enough attention is paid to flies. These insects feed 
on both filth and human food and not infrequently 
alight on our food with their feet covered with typhoid 
germs. It is easy to see how under such conditions 
bacteria may be taken in with our food. If conditions 
are favorable to growth and reproduction such bacteria 
produce toxins which are sometimes so powerful as to 
cause prostration and even death. 

Curiously enough, some persons may harbor disease 
germs and not have the disease. There are a few cases 
on record where the germs of diphtheria or typhoid 
have been growing and reproducing in the bodies of 
persons who have never had the disease. Such persons 
are called " carriers " and they may cause epidemics of 
disease. One of the best known " carriers " is a woman 
in New York who was employed as a cook for years. 
She is know T n as" Typhoid Mary " and the New York 
City Department of Health has traced to her over 
twenty cases of typhoid in families where she has been 
employed. The Department of Health was able to se- 
cure from her a promise that she would not seek em- 
ployment as a cook. In 1914 typhoid broke out in a 
maternity hospital in New York and several mothers 
and babies were infected. An examination of the milk 
and water failed to show the method by which the dis- 
ease had been transmitted, and it was only after a visit- 
ing physician had recognized a worker in the kitchen as 
M Typhoid Mary " that the epidemic was controlled. It 



MAN AND DISEASE 



29 



is supposed that she transmitted the disease to the pa- 
tients in the hospital by means of salads, the fresh veg- 
tables of which she prepared for the wards. 

13. How does the body fight disease? One natu- 
rally wonders why it is that disease is not more pre- 
valent, when one considers how closely human beings 
associate to-day, through how many hands food passes, 
and how careless some persons are about sneezing and 
spitting. We should exercise the greatest vigilance to 
prevent the acquisition or transmission of disease. If 
we do we can cut down the death rate appreciably. 
This is clearly recognized by the health departments in 
all of our States. In New York, the State Department 




PfOtOpli 



A B C D E, 

Fig. 13. — A white blood cell eating a bacterium 

of Health has adopted a slogan, " Public Health is Pur- 
chaseable." Think about this statement and you will 
discover several ways in which public health is pur- 
chaseable. If we try to live up to the rules and laws 
laid down by Departments of Health, we will find that 
we have a good friend in Nature to whom disease is 
sinful. We have been endowed with very wonderful 
bodies, made up of parts which work together in a very 
delicate harmony, providing they are not abused by 
excesses or lack of exercise or by poisons from without. 



30 HEALTH AND EFFICIENCY 

In order to keep out disease germs, Nature has clothed 
us in a tenacious tissue of skin. Sometimes this be- 
comes torn or cut and disease germs get into the blood 
stream. Does this mean that we get a disease? Not 
necessarily, for moving about in the blood are tiny cells 
which act as the policemen of the body. These cells 
are not exactly like the cells that we found in the leaf of 
the lily, for in the first place, they are not joined to- 
gether, but move about independently of one another; 
furthermore, they have no cell wall and each one is 
capable of changing its shape. There are millions of 
them in the blood stream, moving about through the 
tissues, seeking germs which they may destroy. Fig. 
13 shows one of these cells attacking a bacterium. 
They are called white blood cells, or leucocytes. When 
a leucocyte approaches a germ, it spreads out its proto- 
plasm, gradually surrounds the germ, kills and digests it. 
Germs, then, are the food of leucocytes and we should 
do all that we can to insure vigor to our bodies in order 
that these policemen may always be active. It has 
been discovered also that the liquid part of the blood 
contains chemicals which have the power of rendering 
disease batceria harmless. From the fact that the 
blood has the power of killing germs it is said to be 
germicidal. The germicidal power is not constant, 
however, but varies with individuals and with condi- 
tions. 

14. How can man help Nature fight disease? As 
was pointed out in the preceding paragraph, a cut or 
a torn skin may be the portal for the entrance of dis- 
ease germs, which may develop into a serious case of 



MAN AND DISEASE 



31 



blood poisoning or anthrax. Blood poisoning is a dis- 
ease in which certain kinds of germs are found circu- 
lating in the blood. Anthrax is a disease of cattle and 
sheep in which ulcers are formed and severe symptoms 
of collapse are seen. It is found from time to time 
among human beings and is said to be transmitted 
by shaving brushes, furs, and the hides of ani- 
mals. While the leucocytes may be successful in their 




Fig. 14. — The scarlet fever ward of a modern hospital 

fight against disease sometimes, often they are unsuc- 
cessful. We must not leave all to Nature, therefore, 
but must assist Nature at every turn. A pin prick, a 
bleeding gum, an inflamed tonsil, or a sliver in the 
hand may seem to be too trifling to need attention, but 
we know now that such is not the case. A bruise 
should first be cleaned of such foreign matter as dirt 
and then washed with an antiseptic of which there are 
many kinds. Can you give the names and methods of 



32 HEALTH AND EFFICIENCY 

applying three? After the bruise has been cleaned 
and washed with an antiseptic, a clean bandage may be 
applied to keep out more germs. This treatment, if 
applied immediately, will usually suffice, as the antisep- 
tic should check the growth of the bacteria or in some 
cases kill them. 

15. What happens when we are vaccinated. An- 
other, more complicated method of fighting disease was 
discovered by an English physician named Jenner. 
Jenner had been told by people in the country districts 
of England that milkmaids were not apt to be infected 
with smallpox, which w r as, at that time, a very horrible 
and common disease. He investigated the story and 
found it to be true. The reason was that the women in 
milking got on their hands some of the pus from the 
cowpox, which commonly affected the cattle and which 
is probably a mild form of small pox, and this 
pus gained entrance to the blood through cuts, etc., 
in the skin. In the blood the pus of the cowpox 
stimulated the tissues to form chemicals which had a 
germicidal property toward any smallpox germs which 
might later gain entrance into the body. Such a per- 
son was, therefore, immune to smallpox, and the im- 
munity had been acquired. While some persons are 
immune to smallpox from birth, and are consequently 
said to be naturally immune, most persons are easily 
susceptible to it. In view of this, and in view of the 
virulence of the disease, it is advisable to adopt the 
procedure advocated by Jenner, that of vaccination. 
This consists in scratching the skin with a pointed 
instrument and rubbing into the tissues under the skin 



MAN AND DISEASE 



33 



the virus taken from blisters or swellings found on 
cattle with cowpox. In a few days a small solid ele- 
vation appears at the site of inoculation, folowed in a 
few more days by a small sac, filled with liquid. After 
eight days the area around the sac becomes red and 
finally a scab forms. This later falls off, leaving a 
scar. The process of vaccination is therefore a sim- 
ple one and at the same time so efficacious that it has 
been called the greatest single benefit ever conferred 




Fig. 15. — A Red Cross boat taking little sufferers for a 
day's outing 

by one man upon the human race. The value of it was 

indicated sharply at the time of the Franco-Prussian 

War. An epidemic of smallpox was raging and the 

German soldiers had been vaccinated against it while 

the French had not. The German mortality from the 

disease was 450, while the French was 23,400. 

16. Diphtheria and the use of antitoxin. It is said 

that a king of ancient Greece accustomed himself to 

poison by taking it in very small doses and gradually 



34 HEALTH AND EFFICIENCY 

increasing the amount until the ordinarily fatal dose 
had no effect. It was discovered about 25 years ago 
that diphtheria germs grown in broth produced a poi- 
son, or toxin, which could be injected into an animal 
in gradually increasing doses, until a dose, large enough 
to kill a great many animals which had not been accus- 
tomed to it, could be given. Later, it was learned 
that the blood serum from such an animal, if injected 
into another animal, rendered the latter immune 
to the poison. The reason for this is that the blood 
of the first animal developes an antitoxin to neu- 
tralize the toxin from the diphtheria germs. This anti- 
toxin is known as diphtheria antitoxin and is now pre- 
pared from the blood of horses. In cases of suspected 
diphtheria the first treatment consists in the introduc- 
tion of diphtheria antitoxin into the blood of the pa- 
tient. It can not be too strongly emphasized that this 
must be done as early as possible. Do not neglect to 
consult a physician in case you have a sore throat in 
which a white patch can be seen ; or when the sore 
throat has developed after exposure to a known case 
of diphtheria ; or when you have a sore throat accom- 
panied by fever and general indisposition. 

17. The treatment of disease by the use of 
serums and vaccines. The blood is made up of a solid 
and liquid portion. If it is allowed to clot, a solid por- 
tion may be strained off, leaving the liquid portion, or 
serum. We have seen in the case of diphtheria and 
smallpox, that the serum of an animal may, under cer- 
tain conditions, contain substances called antibodies 
which are able to counteract or neutralize the poisons 



MAN AND DISEASE 



35 



or toxins of disease germs. In some cases the anti- 
bodies of smallpox are present in the blood from birth 
and persons who are so fortunate do not contract small- 
pox and they are said to be naturally immune to the 
disease. On the other hand the antibodies, or else sub- 




Copyright by Underwood & Underwood 

Fig. 16. — Former Surgeon General Gorgas, especially 
noted for his work in freeing Havanna from 
yellow fever 

stances which will cause the tissues to produce them, 
may be injected into the blood and the person may 
thus acquire an immunity to the particular disease. 
Since each disease germ produces its own specific poi- 
son or toxin, the antitoxin or antibody used must be 



36 HEALTH AND EFFICIENCY 

the specific one which will neutralize that particular 
toxin. Antibodies is the general term used to indi- 
cate the protective substances which are generated by 
the animal against the invading disease germ. Anti- 
toxin is one variety of antibody. 




Copyright . by Underwood & Underwood 

Fig. 17. — Dr. Wilfred T. Grenfell, Medical Missionary 
of the Frozen North 

Usually the most lasting form of immunity is that 
which is acquired by the tissue cells of the animal pro- 
ducing specific antibodies against the invading germ. 
A lasting degree of this form of immunity usually fol- 
lows recovery from smallpox, scarlatina, measles, and 
typhoid fever. As a result, the individual does not have 



MAN AND DISEASE 37 

a repetition of the particular disease. In other diseases 
— pneumonia for instance — the immunity, if present 
at all, lasts for only a short time. In either case, the 
degree of immunity is not in proportion to the severity 
of the disease, since a lifelong immunity may follow a 
mild infection, or a severe infection may be followed 
by no immunity, or one of short duration. 

The foundations of the science of immunity were 
laid by Pasteur, who found that he was able to 
produce a form of chicken cholera germ which he 
could inject into fowls without producing a severe 
form of cholera. Pasteur accomplished this by 
cultivating the germ over a long period of time, 
so that the strain became weakened. Injection of this 
weakened germ caused the tissues of the fowl to pro- 
duce the specific antibodies and thereafter the fowl was 
immune to any form of the disease. Pasteur later 
found that germs could be weakened by exposing them 
to certain temperatures for varying lengths of time, 
and also, in the case of one disease, the virus (the ma- 
terial supposedly containing the germ) could be weak- 
ened by drying. 

Artificial immunity may be produced by (a) the use 
of a serum or (b) the use of a vaccine. By serum 
therapy we mean the process of immunization induced 
for the purpose of preventing or curing a disease, by 
means of the injection into the blood of the serum of 
another animal which has been actively immunized, 
against the particular disease. An example of this 
process is the injection of diphtheria antitoxin. Vac- 
cine therapy differs from serum therapy. It is the 



38 HEALTH AND EFFICIENCY 

process of making the tissues immune by the injection 
of dead bacteria directly into the tissues. An instance 
of vaccination by the injection of disease germs is that 
of typhoid vaccination. The typhoid vaccine is pre- 
pared by putting a definite number of typhoid bacteria 
in salt water and heating them until they are dead. If 
this weakened germ is injected under the skin the pro- 
cess is not followed by any lasting ill effects and a high 
degree of immunity is produced. 



CHAPTER III 
POSTURE AND EXERCISE 

18. Posture and military life. The importance of 
maintaining good posture in order to secure good 
health and also the prevalence of remedial defects of 
posture were brought forcefully to our attention in 
1917, when it was found that a large percentage of the 
young men of the country subject to military service 
were unfit for such service because of physical defects. 
The examining physicians were amazed at the number 
of cases of flat feet, spinal curvature, hollow chests, 
and protruding abdomens. So general were these de- 
fects that the following letter was sent out from the 
Office of the Adjutant General at Washington : 

44 Perhaps the most glaring faults noted in aspirants 
to the Officers' Reserve Corps and one that might be 
corrected by proper attention in our high schools, pre- 
paratory schools, and colleges, might be characterized 
by the general word ' Slouchiness ' I refer to what 
might be termed a mental and physical indifference. I 
have observed at my camp otherwise excellent men who 
have failed because in our school system sufficient em- 
phasis is not placed upon the avoidance of this mental 
and physical handicap. 

" At military camps throughout the country mental 

39 



40 



HEALTH AND EFFICIENCY 



alertness, accuracy in thinking and acting, clearness in 
enunciation, sureness and ease of carriage and bearing 
must be insisted upon, for two reasons — that success 
may be assured as nearly as human effort can guarantee 
it with the material and means at hand, and that price- 
less human lives may not be criminally sacrificed. Only 




From plate loaned by the American Posture League. 

Fig. 18. — In the middle a girl in good posture. What 
are the defects of posture shown by the girls on 
each side ? 

by the possession of the qualities referred to does one 
become a natural leader. 

" A great number of men have failed at camp because 
of inability to articulate clearly. Many men disquali- 
fied by this handicap might have become officers under 
their country's flag, had they been properly trained in 
school and college. 

" It is hoped therefore that more emphasis will be 



POSTURE AND EXERCISE 41 

placed upon the basic principles of elocution in the 
training of our youth . . . Great improvement could 
be wrought by instructors in our schools and colleges, 
regardless of the subject, insisting that all answers be 
given in a loud, clear, well rounded voice, which, of 
course, necessitates the opening of the mouth and free 
movement of the lips. 

u In addition to this physical disability and slouch- 
iness is what might be termed the slouchiness of mental 
attitude. Many men have not been trained to appre- 
ciate the importance of accuracy in thinking. Too 
many schools are satisfied with an approximate answer 
to questions. Little or no incentive is given increased 
mental effort to coordinate one's ideas and present them 
clearly and unequivocally . . . 

" I have further noted at camp that even some of 
our better military schools have turned out products 
that, while many of them have the bearing of a soldier 
in the ranks, yet their carriage is totally different as 
soon as they ' fall out.' Schools, military and non- 
military, should place more insistence upon the bearing 
of pupils all the time. It should become a second na- 
ture with them to walk and carry themselves with the 
bearing of an officer and a gentleman. 

" As a last important element that seems to me has 
been lacking in the moral and mental make-up of some 
of our students here, is the characteristic of grit. Not 
that they would have proven cowardly in battle, neces- 
sarily, but some have exhibited a tendency to throw up 
fhe sponge upon the administration of severe rebuke 
or criticism. Their * feelings have been hurt ' and they 



42 



HEALTH AND EFFICIENCY 



resign. They have never been taught the true spirit 
of subordination. They are not ready for the rough 
edges of life. The true training school should en- 
deavor to keep one's eyes fixed upon the goal rather 
than upon the roughness of the path, to realize that 
one unable to rise above the hard knocks of discipline 
cannot hope to face with equanimity the tremendous 




From plate loaned by the American Posture League 

Fig. 19. — In the middle a boy in good posture. What are 
the defects of posture shown by the boys on 
each side? 

responsibilities of the officer under modern conditions 
of warfare. This ideal of grit belongs in the school 
room as well as upon the campus. ,, 



POSTURE AND EXERCISE 43 

In spite, however, of the general slouchiness re- 
ferred to here, and of other defects of posture, the mil- 
itary authorities, by patient and intelligent direction, 
were able to accomplish wonders with the material with 
which they had to work. Many young men will owe 
not only sound health but success in business and pro- 
fessional life to the careful training of their bodies, 
which they received during their period of service. 

19. Bad posture may be the result of disease. The 
importance of bad posture as a symptom of disease has 
probably not received the attention that it deserves. 
Bad posture is too often considered merely a lack of at- 
tention to proper carriage. Of course, in many cases, 
it is this, but very often it is the definite result of a dis- 
eased condition. The effect of disease on posture is 
very marked in the case of tuberculosis. Every one 
has noticed the emaciation, the hollow chest, and the 
stoop — the consumptive stoop — so characteristic of 
this disease. One eminent physician has said that the 
first remedial measure which he undertakes with a tu- 
bercular patient is to recommend the daily perform- 
ance of physical exercises calculated to correct the de- 
fect of posture. 

The stoop caused by a rheumatic condition, partic- 
ularly in old people, is a matter of common observation. 
That defective posture may be the result of nervous 
exhaustion or of some organic debility, has not been 
so clearly noted. In the case of boys and girls of 
high school age, poor posture, especially when asso- 
ciated with paleness and a loss of appetite, may indicate 



44 HEALTH AND EFFICIENCY 

illness. Pains in the abdomen are often relieved by 
pressure secured by bending forward. This act re- 
peated frequently may result in the permanent acquisi- 
tion of a stoop and the consequent disregard of the 
original trouble. Defects of posture among children 
are very frequently the result of diseases of the bones 
such as " rickets," which, in turn, has been brought on 
by an unbalanced diet. Among school children, poor 
posture is frequently induced by eye and ear defects. 
Failure to hear distinctly with one ear tends to a tilting 
of the body in the directions from which the sound 
comes. Poor eyesight usually results in an effort to 
bring the eyes toward a book rather than in an effort to 
bring the book toward the eyes. Close attention to the 
posture of the patient is a distinct aid to the physician in 
the diagnosis of disease. 

20. Bad posture may be the cause of disease. 
Man, unlike most of the lower animals, walks upright. 
The normal position of the human body when standing 
is such that the neck and trunk form a straight vertical 
line. This position is well illustrated by a drawing pre- 
pared by the American Posture League. In this posi- 
tion the organs of the body are not unduly compressed 
and the nervous and circulatory systems in particular 
are allowed full play for their functions. In this po- 
sition, the spinal column, or backbone, supports the 
head in such a way that one not only looks alert, but 
feels alert. The head is well balanced and the eyes 
look straight forward. This point deserves more at- 
tention than it usually receives. William James, the 
celebrated psychologist, believed that posture has a 



POSTURE AND EXERCISE 



45 



great deal to do with the emotions ; that an attitude of 
courage, with the head up, chest out, and hand clenched, 
engenders courage ; and that a low, slouching, limp pos- 
ture engenders cowardice. Moreover, when the body 
is carried properly, the nerve branches from the brain 
and the spinal cord are not pinched off or stretched and 
their function thus interfered with. 





Mormal fool 



Hal-fool 



Fig. 



20. — Imprint of a normal foot and of one with a 
fallen arch 



The arrangement of the bones of the skeleton is such 
that, with the body in correct posture, the heart beats 
freely and the stomach is afforded support so that it 
does not sag and allow food to stagnate. There is some 
reason to believe that a habitual stoop leads to tubercu- 
losis. In cases where one shoulder is lower than the 
Other the ribs are crowded together on that side leaving 



46 HEALTH AND EFFICIENCY 

less space for lung movements and consequently de- 
creasing the amount of air taken into the body. On the 
side of the high shoulder fresh air does not get up into 
the top or apex of the lung, a stagnant condition results, 
and the germs causing consumption multiply rapidly. 
It is also the experience of physicians that a bending 
forward of the body crowds the organs of the abdomen 
downward, and, by pressing these organs against one 
another, causes a stagnation of food and waste in the 
bowel, and of blood in some neighboring structures. 
As a result of this condition, intestinal disturbance 
known as " constipation, diarrhea, flatulence, (collec- 
tion of gas), disturbances of circulation, headaches, ner- 
vous irritability and, most marked of all, fatigue out of 
proportion to effort expended, lessen the efficiency of 
the individual and often make life a burden/' 

21. The elements of good posture. These, so far 
as they apply to posture while walking or standing, 
have been mentioned — the neck and trunk form a 
straight, vertical line. This posture is one requiring of 
the body the least energy to hold it upright. The Amer- 
ican Posture League has found by repeated investiga- 
tions that " it is also the posture in which the internal 
organs rest in their natural positions and relations, 
with adequate room to perform their functions. " This 
same society has also found that " the principles of 
correct seating require comfortable support of the feet, 
thighs, and usually of the back, for work or rest, as 
the case may be. The seat should be of a height to per- 
mit the feet to rest comfortably on the floor. The arms 
should be so modeled as to favor sitting with the pel- 



POSTURE AND EXERCISE 



47 



vis as close to the back of the chair as possible; this 
prevents sliding forward and distributes the pressure 
properly. The front of the seat should be rounded so 
as not to press against the legs. The back of the seat 
should have a slight backward slope and afford support 





In FLARED 



OUTFLARED 



Straight 



Fig. 21. — The American Posture League, after a very 
extensive study, has concluded that there are three 
main types of feet. They are now designing lasts 
from which shoes of these three types can be made 

to the small of the back. Seats modeled along the lines 
indicated were adopted by the Brooklyn Rapid Transit 
Company and are now in use in the Brooklyn Subway. 
The league has also designed a chair which em- 
bodies the desirable points enumerated above. This 



48 HEALTH AND EFFICIENCY 

chair has been adopted by several communities for 
school room use and has given great satisfaction. 

The American Posture League (i Madison Ave., 
N. Y. City) issues a pin for good posture. The design, 
made especially for the League, shows an American 
Indian in profile on a small oval. Good Posture So- 
cieties should be organized in all schools and these pins 
can be used for insignia. 

22. Other defects of posture. Besides the hollow 
chest, protruding abdomen, and the round shoulders 
there are defects of the lower extremities, notably flat 
feet. The service draft examination showed that one 
person out of every five examined had flat feet. 
In the normal human foot there is an arch under the 
instep. This arch is formed by the bones of the foot 
being drawn upward by muscles and ligaments. If 
the muscles weaken in any way, the pull on the extrem- 
ities of the arch decreases and the arch " falls " result- 
ing in a flat foot. The collapse of the bony arch com- 
presses the bloodvessels and nerves under it. In con- 
sequence, the circulation of blood is impeded and the 
pressure on the nerves produces pain which may extend 
up to the back and abdomen. Many pains thought to 
be due to diseased kidneys are produced by fallen 
arches. Fig. 20 shows imprints of a normal foot and 
one in which the arch has fallen. These imprints may 
be made by moistening the sole of the foot and then 
placing it on a dry surface like that of the floor. The 
arch may h.e prevented from falling, or fallen arches 
may be corrected even, by exercises which call for the 
use of the muscles of the feet; such exercises, for in- 



POSTURE AND EXERCISE 49 

stance, as rising on the toes, with the toes turned in- 
ward, and turning on the ankles, both outward and in- 
ward. 

It has been ascertained by extensive inquiry that there 
are three main types of feet as shown in Fig. 21. It 
follows, therefore, that no one type of shoe will fit all 
feet. Shoes are being constructed over lasts of the 
three types, designed by the technical committee of the 
American Posture League. Men and women are learn- 
ing that more attention must be paid to fitting the shoe 
to the foot, rather than the fitting of the foot to the 
shoe. The wearing of improperly fitted shoes results 
in the formation of blisters, bunions, callouses, " corns," 
etc. These not only deform the foot and detract from 
the grace of the body but are often the source of con- 
siderable annoyance and pain. A person having defec- 
tive feet should first secure the services of a chiropodist 
and afterward wear the proper type of shoe. When 
the feet pain — for instance from standing and not 
from any physical defect — putting them in hot or cold 
water for five or ten minutes at night will often give 
relief. Persons who walk a great deal on pavements 
or cement floors should wear rubber heels to lighten 
the shock. 

The wearing of high heels is detrimental to the foot 
and to the body generally. It causes a pronounced 
shock to be sent to the spine and brain, resulting in 
pains in the region of the back and in headaches. The 
practice cannot be too strongly condemned. 

23. Corrective exercises. The exercises listed be- 
low, prepared by the Physical Training Department of 



50 



HEALTH AND EFFICIENCY 



New York City have been found after extensive exper- 
ience to be useful in preventing or even correcting de- 
fects of posture. Either these exercises or others of a 
similar nature may well be performed on rising and 
before retiring and also as a setting up exercise at the 
beginning of a class room period. Before starting the 




Fig. 22. — These seats, designed by the American Posture 
League, are now in use on the Brooklyn Rapid 
Transit lines 

exercises loosen the clothing as much as possible and 
open the windows. 

i. Breathing. 4 times. 

In ! Six counts for inhalation. 

Out! Four counts for exhalation. 

Right (Left) : — Face! 



POSTURE AND EXERCISE 51 

2. Stretching. 4 times. 

This exercise must be done to Response Commands, 
using the cues indicated. 

Bend ! Bend the trunk forward, touching hands 
to toes. 

Shoulders! Stand erect, touching hands at 
sides of shoulders in passing to the next po- 
sition. 

Stretch ! Stretch the arms upward, palms to- 
ward each other. Do not bend backward. 

Higher! Make an effort to stretch higher. 

Down ! Turn hands and bring arms sideways 
downward quickly, without noise. If the 
room is too crowded for the sideways down- 
ward movement, the arms may be brought 
down close to the body. 

3. Knee Bending. (Thumbs locked behind with- 

out command). 8 times. 
This exercise should be taught, using the cues indi- 
cated; when it is thoroughly learned, it may be done 
to Rhythmic Commands. 

Down ! Bend the knees deeply. 

Up ! Stretch the knees quickly. 

Right (Left) : — Face! 

4. Breathing. 4 times. 

In ! Six counts for inhalation. 

Out! Four counts for exhalation. 

Class : — Sit ! 
24. Out of door and gymnastic exercise. Every 
boy and girl should take part in some out of door game 
and endeavor to become proficient in it. Swimming, 



52 HEALTH AND EFFICIENCY 

skating, golf, tennis, walking, hunting, and fishing all 
provide moderate exercise and contact with Nature. In 
congested cities, opportunities along these lines are lim- 
ited and recourse should be had to the gymnasium. 
Gymnastic clubs can develop keen competition, strong 
bodies and well toned nerves. 

25. Athletics. It has been pointed out repeatedly 
that the remarkable adaptability of the American youth 
to modern warfare was due largely to his training in 
athletics. The lessons of courage, resourcefulness, and 
even chivalry, learned on the ball field, were quickly 
transferred to the battle field. These qualities made the 
American fighting man the equal of any the world has 
ever seen. " We can kill them but we cannot stop 
them, ,, the Germans are said to have complained. Even 
in peace times, a sound, athletic body is a very great 
help to anyone. It makes possible more and better 
work and encourages a healthy optimistic outlook on 
life. " Grouches " and " dyspeptics " are not found 
very often among athletes. Mere muscular strength 
is not the goal to be aimed at but rather organic vigor 
together with whatever muscular development may be 
needed to adapt one to the game or activity in question. 
Boxing, baseball, basket ball, and football develop 
these qualities remarkably well. Participation in these 
games has demonstrated repeatedly that, to be in con- 
dition, one must avoid overeating, carousing, smoking, 
and drinking. A sound mind in a sound body, together 
with sound morals, make up the perfect American. 

There are certain precautions to be taken, however, 
if one is to take part in athletics. First, one should 



POSTURE AND EXERCISE 



53 



be examined by a physician. If a defect of any organ 
is found the physician should indicate the exercise that 
will correct it, and should give advice as to what forms 




Fig. 23. — Photograph of a chair designed by the 
American Posture League. What advantages does 
this chair have over the ones in common use ? 

of athletics are to be avoided. Secondly, it should be 
kept in mind, as pointed out before, that the develop- 
ment of huge muscles is not what is desired. Thirdly, 



54 



HEALTH AND EFFICIENCY 



one should not give up strenuous exercises suddenly. 
After a dash along the track, the runner should not 
come to a dead stop at the tape, but should gradually 
decrease the gait to a walk. This gives the heart a 
chance to adapt itself to the new condition. Finally, 
after any strenuous exercise, one should bathe in warm 
water to remove the perspiration and should follow 
the warm water with cold water in order to close the 
pores of the skin and send the blood to the interior of 
the body. 




Copyright by Underwood & Underwood 

Fig. 24. — East meets West at tennis 

26. Health admonitions from Walter Camp's In- 
sruction Book for the Senior Service Corps. 

Warm feet and a cool head need no physician. 

A bath, cool if you please, hot if you must, with a 
good rub, starts the day right. 

Dress cool when you walk and warm when you ride. 

Wearing the same weight underclothing the year 
around will save you a lot of colds. 

Your nose, not your mouth, was given you to breathe 
through. 



POSTURE AND EXERCISE 55 

Clean skin, clean socks, clean underwear every day. 

Don't sit still with wet feet. Walk until you have a 
chance to change. 

Never let a day pass without covering four miles on 
foot. 

See how high you can hold your head and how deeply 
you can breathe whenever you are out of doors. 

Hot water quick is the best thing for a sprain. 

Short shoes and shoes that don't fit cost a lot in the 
long run. 

Getting mad makes black marks on the health. 

Envy, jealousy, and wrath will ruin any digestion. 

When you rob the trolley company of a nickel by 
walking, you add a dime to your deposit of health. 

You'll never get the gout from walking. 

Sleep w r oos the physically tired man ; she flouts the 
mentally exhausted. 

The best record in golf is the record it has made 
of restored health to the middle-aged. 

Tennis up to the thirties, but golf after forty. 

Nature never punished a man for getting his legs 
tired. She has punished many for getting their nerves 
exhausted. 

Two hours of oudoor exercise by the master never 
yet made him over critical of the cook. 

Don't ask the heart to pump extra blood to the brain 
all day and then to an overloaded stomach all night. 

Tight shoes have sent many a man to bed with a cold. 

Leg weariness never yet produced brain fag. 

Loose clothes, loose gloves, easy shoes spell comfort 
and health. 



56 



HEALTH AND EFFICIENCY 



No wise athlete stands still after exercise without 
putting something over him. 

Open windows don't make half as many colds as 
closed ones do. 

Blood pressure does not come to the men who walk 
a lot out of doors ; instead it looks for those who sit 
and eat a lot indoors. 

Many a man finds too late that his motor car has cost 
him more in health and legs than it has in tires and 
gasoline. 




Copyright, Underwood & Underwood 

Fig. 25. — Championship game of baseball 

A four or five-mile walk daily makes your credit at 
the bank of health mount up steadily. 

Nature won't stand for overdrafts any more than 
your bank. 

The men who chase the golf ball don't have to pur- 
sue the doctor. 



CHAPTER IV 
AIR AND BREATHING 

27. What contact with air does for the body. 

Many persons think that the only use for air is for 
breathing, and that the only use for water is for 
drinking. They have not learned what physicians have 
found, that mere contact with air and water have a 
very decided effect in keeping the body in a healthy 
condition and even in restoring it to health when it 
has been invaded by disease. So true is this that one 
of the most successful forms of treatment for con- 
sumption and nervous diseases in children consists in 
allowing the children to romp and play, attired only in 
as much clothing as decency requires. The healthy 
response which the body shows to this form of treat- 
ment is remarkable and its fulh explanation is not 
known. 

It is a matter of common observation that persons 
living out of doors have a healthier complexion and are 
more energetic than those living indoors. This is, of 
course, explained partly by the beneficial action of 
sunlight on the body and partly by the increased mus- 
cular action induced by the out of doors. A change of 
air temperature, either from the day to the night or 
from summer to winter, is probably best suited to the 

57 



58 HEALTH AND EFFICIENCY 

healthy functioning of the body. Every one should 
take full advantage of fresh, cool air, particularly those 
suffering from any wasting disease or from any disease 
of the nervous system which may be produced by 
overwork or worry. 

28. Howi and why we breathe. Our bodies are in 
some respects like steam engines. For instance, they 
require fuel. A steam engine drawing a train of cars 
has to be kept constantly supplied with coal. If the 
fire box of the engine is not sufficiently supplied with 




Copyright, Underwood & Underwood 

Fig. 26. — East meets West at football 
(Harvard vs. Michigan) 

this fuel, it is unable to perform the work that is nec- 
essary to draw" such a heavy load. We need to w r ork 
just as much as an engine does. An engine that can- 
not perform work is useless, and so is a human body. 
To perform work our bodies must have fuel in the form 
which they can use ; for instance, bread, potatoes, meat, 
and milk. But every one has noticed that, in order to 
have fuel burn in a stove or fireplace, it is necessary to 
have the dampers open so that a draft or current of air 
may come in contact with the fuel. If for any reason 
sufficient air does not pass through the fuel, the fire 



AIR AND BREATHING 59 

burns down. In like manner, our food will not be 
burned and we will not be provided with heat and 
power to work, unless our bodies are supplied with a 
constant stream of air. We are all conscious of breath- 
ing — we have noticed the nostrils dilate, the chest rise 
and fall, and we have felt the passage of air through 
the mouth or nose, the back part of the throat, and 
down into the chest. Most persons know that they 
have lungs but few could describe them. 

The best way to get an idea of what the lungs look 




Photograph from Underwood & Underwood 

Fig. 27 — What is the source of the energy used by this 

engine? 

like is to ask a butcher to show you the " pluck " of a 
calf. This consists of the windpipe, which conducts 
the air down from the throat, the two lungs, and be- 
tween the lungs, the heart. An examination of the 
lungs will -show them to be pinkish in color, due to the 
presence of blood, and very compressible. If one takes 
a pocket knife and slits open the windpipe and then 
follows it down into the lungs he will find that it di- 
vides into two main branches, one going to each lung. 
Each subdivides, and these subdivisions finally end in 



60 



HEALTH AND EFFICIENCY 



the spongy tissue of which the lung is composed. This 
spongy lung-tissue is easily compressed by the muscles 




Fig. 28. — Showing workmen cutting pearl shell unpro- 
tected from the excessive and dangerous dust 

and ribs in the chest wall ; but when the pressure is re- 
leased the lung returns to its normal expanded position 



AIR AND BREATHING 61 

and sucks in air from the outside through the windpipe, 
mouth, and nose. When the air reaches the lung-tissue 
it almost comes in contact with the blood, giving to 
the blood a remarkable substance, oxygen, which has 
the faculty of enabling fuel to burn. The blood in re- 
turn for the oxygen, gives back to the air waste pro- 
ducts — carbon dioxide and water, which are likewise 
formed when coal or wood burns. When the chest 
" falls " during breathing the wall of the chest com- 
presses the lungs, and the air containing carbon dioxide 
is forced out along the same path taken by the incom- 
ing current of air. 

29. What we breathe. We are all acquainted with 
the fact that we breathe air. But not every one knows 
what air is. Of course we know that it is a gaseous 
substance, colorless, and that it flows about readily from 
one place to another. It is constantly in motion as we 
are aware from our experiences with " drafts " and 
" winds." But yet what is air? Chemists have found 
that it is made up principally of gases, and biologists 
have found floating about in it other substances — 
some dead, some living, and still others which never 
had life. Two of the gaseous substances composing the 
air, we have already mentioned, oxygen and carbon 
dioxide, but these exist in relatively small amounts as 
is seen from the following table : 

Air that we breathe in Air that we breathe out 

Oxygen 20.96% Oxygen 16.4% 

Nitrogen _ . % 79.00% Nitrogen _ . 79-5% 

Carbon dioxide 0.04% Carbon dioxide 4.1% 

Among the dead substances floating about in the air 
are particles formed from the bodies of plants and ani- 



62 HEALTH AND EFFICIENCY 

mals during decomposition. Among the substances 
which never had life are particles of steel and stone, 
which often get into our eyes. The living substances 
are bacteria, spores of molds, and pollen grains. The 
living bodies found in the air are particularly interest- 
ing because some of them cause disease. The mold 
spores are seeds of the mold which we see growing on 
stale bread, apple cores, etc. These spores are blown 
about by the currents of air and sometimes lodge in the 
ear or nose where they may grow and produce disease. 
Expose a piece of moist bread, a moist apple core or a 
moist banana peel to the air for an hour and then put 
them under a cup to see how many kinds of molds you 
can raise. Bacteria, together with certain kinds of 
one-celled animals, are commonly called " germs " 
They are so small that they can be seen only with the 
aid of a microscope, and yet they kill thousands of peo- 
ple each day, either by secreting poisons in them or 
by actually eating the tissues of their bodies. One 
form of bacteria, in particular, thrives in the soft 
spongy tissue of the lung, consuming it and producing a 
disease which we call consumption. As the germ caus- 
ing this disease eats away more and more of the lung- 
tissue, less and less oxygen can be taken up by the blood. 
At the same time that it is consuming the lung-tissue, 
it is secreting a poisonous substance which is taken up 
by the blood and distributed throughout the body, 
causing a loss of vitality and weight. We should be 
constantly the prey of the tuberculosis bacteria if it 
were not for certain safeguards which Nature has 
thrown about us. First, there are the hairs in the nos- 



AIR AND BREATHING 



63 



trils which act as a sieve, straining out particles of 
dirt and bacteria ; there is also the slimy mucous secre- 
tion of the nostrils, which catches many more invaders ; 
finally the tissues of the lungs are able to offer what is 
called " resistance " to the disease germs, if the body 
has plenty of nourishing food and is given the required 




Fig. 29. — Showing how workers in the process of 
casting brass are protected against zinc fumes 

amount of rest, sleep, and exercise. The importance 
of breathing through the nose rather than through the 
mouth lies in the fact that the nostrils not only pre- 
vent much of the dust from reaching the lungs but 
they also warm the air before it reaches the throat and 
lungs. For this reason it is necessary to have the nos- 
trils well cleared so that nose breathing will be as easy 



64 HEALTH AND EFFICIENCY 

as mouth breathing and far more healthful. There 
are persons, to be sure, particularly in damp climates, 
who fall victims to consumption in spite of the best 
medical care. Some of these persons, at least, have 
inherited weak constitutions, or at least weak lungs, and 
thus start out in life at a disadvantage. 

30. Diseases of the breathing organs. Physicians 
who have had years of experience iri conducting u au- 
topsies," or examinations of dead bodies, say that al- 
most every one has consumption at some time or other 
during his life. They know this from " scars " left 
by the disease in the lungs. If a person keeps himself 
in good condition his body is able to resist the disease 
successfully. So great is the danger from this disease 
that each one should know just what to do to avoid it 
and what to do to combat it. Mention was made in the 
preceding paragraphs of the tendency to tuberculosis 
in damp climates. This same tendency is found in 
damp communities and in damp houses. The tendency 
is found among those who live indoors a great deal, 
particularly among those who inhale large quantities 
of -dust, as men do who work in close, ill-ventilated 
rooms, or in rooms where marble or wood is being pol- 
ished. It is found among those who overwork or un- 
der-exercise ; among those who worry or grieve ; in 
a word among those who do not live out under the 
blue dome of Heaven, as God intended that they should. 
It is, of course, impossible in our present " civilization " 
for every one to do this — we need office workers as 
well as field workers. But those who work inside, 
either through choice or necessity, must guard well 



AIR AND BREATHING 



65 



their health. They should ventilate their work-rooms 
as well as the construction will allow. If the room it- 
self is not adapted for good ventilation, complaint 
should be made to the employer or to the Board of 
Health. Workers have tolerated bad working condi- 
tions too long, and one of the greatest services that can 





i^iiii ^ B 


Ai 




«W 


■ I 


„.d> 


91 iH HI 

III 

■Lk * s lag 




lit * t 




1 '. 


£mk So 




5 




*|kV\ * ill 




m ' ^W MPP*" ' v;.4'g^^^B 


■B 



Fig. 30. — Women at work on small cores in a well 
lighted, well ventilated and well kept foundry 

be done for a community is for students in hygiene 
classes to call attention to these facts through the press 
or by personal interviews with the Health authorities. 

The question now arises, if tuberculosis or consump- 
tion is so general, how is one to recognize it? At one 
time it was very difficult to recognize the disease in its 
early stages but now, with more refined methods of 



66 HEALTH AND EFFICIENCY 

diagnosis, particularly by the use of the X-ray, physi- 
cians are able to distinguish the disease at a very early 
date. It usually causes a loss of energy, loss of weight, 
a cough, and sometimes night sweating. If a person 
is aware of any combination of these symptoms, it 
would be well to consult a physician immediately. The 
disease is not hopeless as many think ; as a matter of 
fact, one of the greatest monuments erected to the mem- 
ory of the hundreds of self-sacrificing physicians who 
have studied this disease is the successful treatment 
which they have devised for it. A hundred years ago 
the disease was called the '* Great White Plague," and 
its victims considered themselves doomed to a speedy 
death. Now, however, if the consumptive begins in 
time, he can defeat the disease and restore himself to 
normal health by a well-regulated diet and hygienic 
conditions of living. 

Out-of-door living plays a great part in the treatment. 
In the first paragraph of this chapter there was de- 
scribed a new form of treatment for tuberculosis in 
children by means of air baths. The knowledge of this 
form of treatment should be more general, and re- 
course should be had to it whenever circumstances per- 
mit. Fresh air, both by day and night, and plenty of 
nourishing food furnish the key to the cure. 

The question of foods and dietaries form the subject 
of a subsequent chapter, but one should note here that 
certain foods like eggs, milk, cooked and uncooked cer- 
eals, and coarse bread should form the basis of the diet. 
Fats and oils are particularly nourishing to those suf- 
fering from respiratory diseases. It seems impossible 



AIR AND BREATHING 



67 



for one to overeat during the course of the disease, 
though one may overwork. Rest, or at the most, light 
out-of-door work is essential, in order that no new 
strain may be put on the body. And the best rest is 
that which is taken in contact with fresh, cool air. For- 
tunately the prejudice against night air is disappearing. 




Fig. 31. — A disciple of Dr. Trudeau 

The coolness of the night air makes it especially use- 
ful in the treatment of consumption. Of course, if the 
air is cold, the body should be guarded against chills by 
proper street and bed clothing. People thought that 
Dr. Trudeau was crazy when he took his tubercular pa- 
tients to winter in the Adirondacks, where snow lies on 
the ground six months in the year and the temperature 



68 HEALTH AND EFFICIENCY 

often goes as low as 30 degrees below zero. But the. 
patients got well, and now Dr. Trudeau is known as the 
" Beloved Physician/' and a town is named in his honor. 
Boards of Health are always ready to cooperate in an 
endeavor to check this disease and will give the best 
medical advice, and often complete treatment, free of 
charge, to those who need and desire it. In the larger 
cities well equipped clinics for diagnosis, and complete 
sanataria for treatment are provided. 

Another disease of the lungs which causes thousands 
of deaths is pneumonia. People make themselves sus- 
ceptible to the disease by over-eating, overworking, 
over-exposure to cold winds, by going about with wet 
feet, and by neglecting colds. Pneumonia shows itself 
by symptoms of fatigue, chills, fever, and a loss of ap- 
petite. The disease develops so rapidly that it is always 
best, when these symptoms are present, to call a physi- 
cian. Certain first aid measures should be taken while 
awaiting the physician's call. First, one should take a 
physic and put the feet in hot mustard water (one table- 
spoonful of mustard to a gallon of water). Immed- 
iately afterward, one should go to bed and, while keep- 
ing well covered, drink a bowl of lemonade as hot as 
it can be taken. If pains in the chest are present, the 
physician will probably recommend a mustard or flax 
seed poultice ; the use of these, therefore, may be antic- 
ipated. Directions for making the poultices are given 
in Chapter XIII. The directions given above apply 
equally well to ordinary colds, grippe, or influenza. 

31. Problems of ventilation. So much of what 
has been said about air and the diseases of the breathing 



AIR AND BREATHING 



69 



organs is involved in methods of ventilating that it 
seems well to summarize here. Ventilation means 
providing the body with currents of air. It used to be 
supposed that ventilation was necessary because of the 
collection of waste products in the air which came from 
the lungs, and because of the exhaustion of the oxy- 





:! "^pt ; ;^ ; -,,^: ^ ^>;IStg:'' 


1 -' ' ' 


'■"■■'"'■ 'W^-"x '■:■.:■:■ :. . 







Fig. 32. — A well lighted workroom having whitened 
walls, prismatic glass kept clean and shades 
for windows 

gen from the air of the room. It is known now, how- 
ever, that it is not possible to reduce the oxygen supply 
in a room to the danger point by breathing and that 
the ill effect of carbon dioxide is negligible. What 
the body needs most of all is a current of fresh, cool 
air, containing a small amount of moisture. It is be- 



70 HEALTH AND EFFICIENCY 

cause of this fact that we should keep out in the air 
as much as possible during the day and that we should 
ventilate our living rooms day and night by having the 
windows open top and bottom. Rooms ventilated by 
keeping the windows in this condition will enable one 
to work better and sleep better, since there will be a 
constant stream of fresh air into the room, by way of 
the lower part of the window, and a constant stream of 




Fig. 33- — A well ventilated schoolrooom 

heated and vitiated air out, by way of the top of the 
window. If the draft produced by opening the win- 
dow in this way is too severe, a wooden frame, covered 
with cheese cloth and fitted into the bottom of the win- 
dow, will moderate the air current.' 

As an example of the disastrous effects of a failure 
to ventilate, the experience of the British soldiers locked 
in the Black Hole of Calcutta may be cited. About 



AIR AND BREATHING 71 

150 soldiers were confined, during a hot tropical night, 
in a room about 20 feet square, provided with only two 
windows, both on the same side of the room. In the 
morning twenty-three were found alive ! This inci- 
dent has given rise to many theories as to the cause of 
death. There may have been a shortage of oxygen and 
an accumulation of carbon dioxide and other poisonous 
waste products. That these do not constitute the im- 
mediate cause of the loss of 127 lives in one night is 
the prevailing opinion of specialists on ventilation. 
The real cause of the disaster was probably the rise in 
the temperature, due to the presence of so many human 
beings closely confined in a small room. As the tem- 
perature rose, the living conditions became more un- 
bearable and the movements of the agonized prisoners 
rendered the situation increasingly acute. 



CHAPTER V 
FOOD AND DIET 

32. The body considered as an engine. It will help 
us to understand how the human body performs its 
work if we consider first a steam, engine. It may seem 
at first thought that there is little resemblance between 
the two, but yet they bear to one another a very pro- 
found likeness. In the first place, both move and both 
do work. A steam engine, if hitched to a car, can pull 
it, and a man, if hitched to a smaller car, can pull that 
also. Where do they get this ability to do work? 
Since the engine is much the simpler structure of the 
two, we will consider that first. If you watch a steam 
engine as it comes into a railroad station, you notice 
that there are two men in it — an engineer, to start and 
direct it, and a fireman, to supply it with coal. What 
happens to the coal? If you watch the fireman, you 
notice that he shovels the coal into a fire box, where it 
burns. But how does this run the engine? If you ask 
the fireman, he will show you that the fire box is under 
a great tank of water. You know what happens to a 
kettle of water when it is put on a hot stove. When 
the water boils, the cover of the kettle moves up and 
down, due to the pressure of steam within. A similar 
change takes place in the engine. The heat of the burn- 
ing coal changes the water into steam, and the steam 

72 



FOOD AND DIET 



73 



moves the piston rod up and down, and the piston rod 
moving up and down moves the wheels around, and so 
the engine is able to do work. In other words, from 
the burning coal comes heat energy and motion energy. 
So in our own bodies, food is burned from which we 
obtain heat and motion energy. A starving person has 
little vitality and does not move about much as only 
a small portion of fuel is being burned in his body. On 
the other hand, during some diseases such as influenza, 



■Ji..JL*— La 1 1 s 


iiiS^llll§81 


EBBB 


***** ' 


•■■■' .■■:■; 





Copyright, Underwood & Underwood 

Fig. 34. — Potato farming — potatoes are a valuable food 

fuel is burned too fast, and the person's temperature 
rises, causing what is called a " fever." At other times 
in the same disease, too little fuel may be burned, so 
that the person suffers from a lowered temperature or 
" chill." The temperature of the human body is nor- 
mally about 98.6 F. This is maintained in several dif- 
ferent ways among which are sweating, shivering, and 
drinking hot or cold liquids. If there is a tendency 



74 



HEALTH AND EFFICIENCY 



for the temperature to rise, the body gives off sweat, 
which evaporates on the skin, thus cooling the body. If 
there is a tendency for the temperature to fall the body 
resorts to shivering, which is a very effective means of 
generating heat. In disease, it is frequently necessary 
to produce sweating by hot drinks, such as hot lemon- 
ade, or to give hot baths. On the other hand in chills, 




Copyright, Underwood & Underwood 

Fig. 35- — Rice farming — Transplanting rice shoots, near 
Kyoto, Japan 

it may be necessary to wrap the patient up warm and 
to apply hot flannels or hot water bottles in addition to 
giving hot drinks frequently. 

33. Food as fuel. Not all things that burn are suit- 
able for fuel either for the steam engine or for the hu- 
man body. For instance, the ordinary steam engine is 
not constructed so that it can utilize kerosene or gaso- 
line, and yet both burn. So with the human body. 



FOOD AND DIET 



75 



Substances which can be utilized by the human body as 
fuel or for repair or regulation are known as foods. 
We will first consider those foods which serve as fuel. 
In general, they are the starchy, sugary, and oily foods. 
Under this head would come bread, potatoes, honey, 
and bacon. The Life Extension Institute of New York 
City, of which Ex-President Taft is Chairman of the 
Board of Directors, has compiled in its booklet called 




-v" 



\ : W- 



Copyright by Underwood & Underwood 

Fig. 36. — Threshing wheat 

" Food — Fuel for the Human Machine/' a list of 
fuel foods divided into three classes and arranged in 
such an order that those coming first are the ones giv- 
ing the most energy for the money. 



. Starchy Foods 


2. Sugars 


3. Fats 


Cornmeal 
Hominy 
Broken rice 


Sugar 

Corn Syrup 
Dates 


Drippings 

Lard 
Salt pork 



76 



HEALTH AND EFFICIENCY 



:. Starchy Foods 


2. Sugars 


3. Fats 


Oatmeal 


Candy 


Oleomargarine 


Flour 


Molasses 


Nut margarine 


Rice 


Most fruits 


Peanut butter 


Macaroni 




Milk 


Spaghetti 




Bacon 


Cornstarch 




Butter 


Dried lima beans 




Cream 


Split peas, yellow 






Dried navy beans 






Bread 






Potatoes 






Bananas 







These foods, when used in moderation, are burned in 
the body and release heat and work energy. Where 
does the burning take place ? W£ learned in an earlier 
chapter that the leaf of the lily is composed of tiny 
structures called cells. The same is true of a human 
body. Every organ and tissue of the body is made up 
of cells. It is in these cells that the food is burned, 
being carried there by the blood stream. Each cell is 
like the fire box of the engine since it is the place where 
the chemical energy of the food is changed, by burning, 
into heat and work energy. 

A word of caution should be given here in regard 
to the danger of taking into the body too much starchy 
and sugary food. Starch is digested into sugar, which, 
together with the sugar contained in puddings, candies, 
ice cream etc., is stored in the liver, from which it 
is gradually given to the blood to be fed to the cells. 
The amount of sugar normally present in the blood at 
any one time is very small — less than one per cent. 
But under the constant bombardment of sugar-contain- 
ing foods, the sugar content of the blood may rise 



FOOD AND DIET 



77 



much higher than that, and sugar in large quantities 
is a poison. Mr. Alfred McCann, Food Expert for the 
New York Globe, says that " America has become a 
nation of refined sugar hogs." He says that " the aver- 




<ig- 37- 



Photograph by Underwood & Underwood 

■ Cabbages are a valuable and inexpensive food 



age annual consumption of refined sugars in the United 
States is at least one hundred and fifty pounds per per- 
son. The figures of the Department of Commerce 
show that, in Germany, the consumption is sixteen 



78 



HEALTH AND EFFICIENCY 



pounds ; in France, twenty-eight pounds ; and in Great 
Britain, thirty pounds." In other words the average 
American consumes five times as much sugar as his 
nearest competitor. Mr. McCann says in this con- 
nection, that " the last generation has recorded a fifty 
per cent, increase in diabetic affections." Diabetes 
indicates a dangerous condition characterized by an ab- 
normal amount of sugar in the blood, which acts as a 
poison, it being an alcohol, and produces drowsiness or, 




Copyright by Underwood & Underwood 

Fig. 38. — Harvesting Onions 

if not corrected, unconsciousness. Fortunately dia- 
betes can be controlled by limiting the amounts of 
starch and sugary foods taken into the body. 

34. Food as a tissue builder. When a portion of 
an engine becomes worn out, it has to be replaced by a 
new part. In the human body, cells are continually 
being worn out and new cells have to be built to re- 
place them. During the period of growth, when the 
human body is constantly increasing in size, millions 



FOOD AND DIET 



79 



of new cells are being formed. Where do the mate- 
rials for the new cells come from? We know that in 
the case of the engine the machine cannot repair itself 
or grow. But not so with the human body. The hu- 
man organism, like every other living thing, is able to 
increase its own structure up to a certain limit and also, 




Copyright by Underwood & Underwood 

Fig. 39- — Fresh fruit should be a part of every diet 

within certain limits, repair worn out and diseased 
parts. We know, for instance, that when the hand is 
cut or torn, the surrounding flesh is able to fill in the 
wound with new cells and tissues, until a scar is all 
that remains of the original wound. It is almost in- 



80 HEALTH AND EFFICIENCY 

credible to be told that a machine can repair itself, 
but we have the evidence here. And not only can the 
machine do this, but it procures material for the proc- 
ess by its own exertions. This material we get in our 
food. Not all food can be used as building material, 
just as not all food can be used as fuel. Foods that 
can be used for this purpose are lean meat, eggs, fish, 
chee'se, peas and beans. They all contain a substance 
or nutrient, called protein, out of which new living ma- 
terial or protoplasm can be made. Certain parts of our 
bodies, as for instance the bones, are reinforced by 
mineral substances such as lime. Consequently, foods 
containing lime must be eaten. Cereals and milk are 
examples of these foods. 

The Life Extension Institute, in the booklet referred 
to in the preceding paragraph, provides the following 
list of protein-containing foods in the order of their 
cost. Those giving most building and repair value for 
the money head the list. 

Beans (dried white) Peanuts 



Dried Peas 


Macaroni 


Oatmeal 


Mutton, Leg 


Cornmeal 


Beef, Lean rump 


Beans, dried lima 


Milk 


Bread 


Beef, Lean round 


Bread, whole wheat 


Lamb, Leg 


Bread, Graham 


Eggs 


Salt Cod 


Halibut 


Milk, skimmed 


Porterhouse steak 


Cheese (American) 


Almonds, shelled 



FOOD AND DIET 



81 



The second kind of building material includes a va- 
riety of minerals which help to make bones, blood, and 
other body parts. They are found chiefly in milk, 
cereal foods (when made from whole grains), fruits, 
and vegetables. Of these minerals, lime, iron, and 
phosphorus are especially needed to keep the body in 




Copyright by Underwood & Underwood 

Fig. 40. — Dressing beef for market 

healthy condition. In a diet that daily includes milk, 
green vegetables, fruit, and cereals made from whole 
grains (oatmeal, flaked wheat, wheatena, etc.) there 
is little danger of mineral starvation. Where the diet 
is very limited, with white flour, fats, and sugar form- 
ing the chief foods, there is much danger. A pint of 



82 HEALTH AND EFFICIENCY 

milk a day is the best insurance against lime and phos- 
phorus lack. Cereals, fruits, and green vegetables will 
furnish iron, and may be supplemented by eggs (espe- 
cially yolks) and meat for this purpose. 

Although the primary use of protein is for tissue 
building, it can be used for fuel, inasmuch as it will 
burn. It does not, however, burn as well or as com- 
pletely as the starches and sugars (carbohydrates). 
This can be made clear by a reference to the chemical 
composition of the two kinds of foods. Carbohydrates 
— starch and sugar — are made of carbon, hydrogen, 
and oxygen. When the sugar is burned, carbon di- 
oxide and water are formed, one being a gas, the other 
a liquid. Protein, on the other hand, contains nitrogen 
in addition and consequently, when it is burned, a 
waste product containing nitrogen is formed. This 
substance is urea and may be compared to the ashes 
or clinkers that collect on the grating of a stove. When 
the coal and wood are burned, the carbon dioxide and 
water formed pass into the air, but the part that is not 
capable of burning collects on the grate and has to be 
removed from time to time. It is not advisable, there- 
fore, to attempt to supply the fuel needs of the body by 
using protein. Protein should be eaten sparingly. 
Girls and women are apt to eat too much sugary foods ; 
men and boys too much protein — principally meats. 
A safe rule to follow is — u Meat should not be eaten 
more than once a day." Inasmuch as most foods con- 
tain some protein, the building material needed by the 
body can be obtained from whole wheat bread, milk, 
and cereals. It is to be noted also that, while the body 



FOOD AND DIET 



83 



needs protein, it also needs different kinds of protein. 
The protein of vegetables is different from that of 
meat, and that of milk is different from that of eggs. 
The same point applies to sugars and fats. We should 
endeavor therefore to give the body variety. A person 




Copyright, by United Newspapers, London, Underwood & Underwood 

Fig. 41. — Explorers in the far North or South find it 
necessary to eat much fat. Why? 

who cannot tolerate ordinary desserts can frequently 
take honey or brown sugar or pure maple sugar, and 
in like manner, one who would be poisoned by the pro- 
teins of meats may be able to utilize the proteins of 
vegetables. 

35. Body fat. Just as a prudent man lays aside 
money to be used for emergencies so the body stores, 



84 HEALTH AND EFFICIENCY 

in the form of fat, some of the excess of food taken 
into it. This serves the purpose of filling out the frame 
of the body, of providing a soft oily padding for mus- 
cles, bones, and organs, and also of providing a reserve 
supply of food to be drawn on in case of need. The 
bodies of even the most spare of men contain some of 
this body fat. It is found in small quantities even in 
the tissues of persons who have been much emaciated 
by tuberculosis. There is no constant relation between 
the weight and size of a person and the amount of food 
the body may require. Some very thin individuals eat 
more than stout ones, but the food is burned almost im- 
mediately. On the other hand, a very stout person may 
eat little and yet may keep the same weight — much of 
the food being changed to fat instead of being burned. 
Sugars and starches are most easily made over into 
body fat ; after these, fats ; and least easily, proteins. 
Consequently, a person who is over stout should eat a 
minimum of fat-producing foods ; one who is too spare 
may be made to fill out by eating milk, eggs, and 
cereals. 

Diets too frequently lack fats and oils. It is a mis- 
take to trim the fat from ham, beef, or mutton and to 
throw away bacon gravy and drippings, unless a person 
is poisoned by them. The body needs these substances 
in good variety. A salad made of lettuce or other 
leaves bathed in olive oil, to which a little lemon juice 
may be added, is very nutritious. The fat yielded by 
meats — called drippings — should be kept and used 
for shortening in the making of cakes, pies, and cookies. 

36. Regulating substances. In addition to those 



FOOD AND DIET 



85 



substances which build up the body tissues and which 
yield fuel for the production of heat and work energy, 
there are substances which regulate the intricate ma- 
chinery of the body. These are (a) water, (b) min- 
eral substances, (c) bulky or fibrous foods, (d) hard 
foods, and (e) vitamines. The body needs large quan- 
tities of pure water. It serves to dissolve the digested 
foods, to make blood and protoplasm, and to carry away 




Copyright by Underwood & Underwood 

Fig. 42. — Vegetables are rich in regulating substances 

waste substances from the tissues. Some physicians 
who have given considerable attention to the subject 
say that the body needs from six to eight glasses of 
water a day. Water also introduces into the body 
valuable mineral substances. Some of these, like lime 
and phosphorous, may also be obtained from milk, 
eggs, and cereals. They are particularly important as 
bone-building material. Children from whose diet 



86 



HEALTH AND EFFICIENCY 



these foods are lacking grow up with soft bones and, 
as a result, bone deformities, especially of the legs, de- 
velop. Of the mineral substances iron is one of the 
most important. So important is it that medical fakers, 
playing upon the sympathies of the public, have made 
millions of dollars from remedies containing, or said to 
contain, iron. Iron is necessary for the manufacture of 
good rich blood. The redness of the blood is due to 
the combination of oxygen from the air with an iron 




Copyright by Underwood & Underwood 

Fig. 43. — A suburban vegetable garden 

compound made in the body called haemoglobin. It 
has been discovered by chemists that the composition 
of haemoglobin is very much like that of the green 
coloring matter of plants, and that iron, while it may 
not be present as a constituent of the green coloring 
substance, is present in other parts of the plant cells. 
It is simpler, cheaper, and more efficacious to supply 
the blood with iron through the medium of green vege- 
tables like spinach, dandelions, cabbage, lettuce, and 
beet greens, than through the medium of the various 



FOOD AND DIET 87 

" tonics " and " rejuvenators " advocated by the patent 
medicine press. Fresh vegetables and fresh air are 
very nearly the key to health. The vegetables, in ad- 
dition to supplying very valuable mineral substances, 
provide the body with indigestible fibrous material 
which prevents the solid waste material from clogging 
the bowel. Cereals are, therefore, to be preferred to 
cathartics ! Each table should provide, once or twice 
a day, foods from the following list : 

graham or whole wheat bread 

bran muffins, bran cookies, and bran breakfast foods 
potatoes (boiled or baked) eaten with the skins 
cabbage (those who cannot eat fresh cabbage may be 

able to eat sauerkraut) 
turnips 
carrots 
celery 
spinach 

onions (raw, boiled, or baked) 
lettuce 
parsnips 

apples (eaten with skins on) 
prunes 
figs 

Of the cereals, those containing " bran " are the best 
for a regular diet. Bran is the coat of the grain 
and is largely indigestible, although containing in 
small amounts some very valuable mineral constituents 
needed by the body. Bran should be in every pantry or 
kitchen. If oatmeal is used, a tablespoonful of bran 



88 HEALTH AND EFFICIENCY 

can very well be added to the oatmeal before it is 
cooked, or a teaspoonful can be sprinkled on each plate 
of oatmeal before it is served. It is well to cook cereals 
the night before they are to be used and to warm them 
for breakfast, or at least to soak them over night. In 
this way the grain is made more digestible. Kipling 
remarked, " compressed vegetables and meat biscuits 
may be nourishing — but what Tommy Atkins needs is 
bulk in his inside." 

In addition to foods which owe their bulk to a fi- 




Copy right by Underwood & Underwood 

Fig. 44. — A rice field in Texas 

brous content, there are some foods which may be 
termed hard, such as stale bread and zweiback. These 
foods are particularly good for the teeth and for stimu- 
lating the digestive processes. The tiny particles com- 
posing a crust of bread rub up and down on the sur- 
face of the teeth like so many little brushes, wiping 
away the slimy coating and the particles of soft food 
which may have clung there. In addition, the chew- 



FOOD AND DIET 89 

ing of hard foods strengthens the muscles of the jaw, 
increases the circulation in the gums, and improves the 
tone of the whole body. 

It has been a common fallacy to consider foods and 
diets in terms of fuel and tissue value. As a matter 
of fact, if a person attempted to live on a diet made 
up with these factors only in view, he would soon find 
it insufficient. There are in the coatings of grain, in 
raw milk, in butter, and in the yolk of eggs, substances 
which cannot be detected chemically, but which exert 
a very profound influence in the body. Their presence 
is recognized by the fact that when they are absent 
from a diet, disturbances of the body functions result. 
They are called accessory substances, or vitamines. 
Their absence from the diet of the Japanese soldiers 
during the Russo-Japanese War produced a severe 
nervous disease called beri-beri ; their absence during 
the long voyages of the Cape Cod whalers produced 
scurvy; and their absence from the diet of people in 
certain parts of Italy and of the southern parts of the 
United States may be the cause of pellagra. Animals 
in zoological gardens become diseased if they are fed 
raw meat without a bone attached, but they soon be- 
come well again if given large bones which they can 
gnaw. The authorities responsible for the health of the 
British Navy have discovered that the dried and canned 
food given to the sailors will produce scurvy. This can 
be cured or prevented by the addition of fresh lemon 
or lime juice to the diet. Consequently British sailors 
are familiarly known as u limies." One British naval 
administration attempted to substitute for the juice of 



90 HEALTH AND EFFICIENCY 

the fresh limes and lemons an artificial product but 
soon learned that the vitamines present in the fresh fruit 
are lacking in the artificial variety. 

Beri-befi is a curious disorder found among the 
Filipinos, Japanese, and the nations of East India. It 
begins with a feeling of lassitude and pains in the legs ; 
later the patient becomes unable to walk, breathing be- 
comes difficult, and palpitation of the heart follows. It 
is a disease which affects the nerves particularly. If 
fowls are fed exclusively polished rice, that is, rice 
which has had the outer coat removed, no changes are 
noticeable for several weeks, but suddenly they become 
unable to walk, and die. in a short time if the diet is 
not changed. If, however, unpolished rice is fed, the 
fowls recover. Evidently something is present in the 
coat of the rice which is needed by the body and which 
must be present in very small amounts. 

Pellagra resembles beri-beri in some respects. The 
skin on the backs of the hands and about the neck be- 
comes thickened and rough. Nervous disturbances are 
prominent. The disease occurs among people who live 
on a very restricted diet. 

Scurvy was very common in the past when vegetables 
were rare, and salted or otherwise preserved meat was 
eaten in quantities. It is not known what particular 
substances are responsible for it, but it can be pre- 
vented by eating the juices of limes, oranges, or lemons. 
Among children, an exclusive diet of boiled or steril- 
ized milk sometimes produces scurvy. Orange juice 
appears to prevent this. 

37. Summary. We have learned, up to this point, 



HEIGHT and WEIGHT TABLE for GIRLS 


Hgt: £ 
Ins: Y] 


■■> 6 
-s. Yrs. 


7 
Yrs. 


8 
Yrs. 


9 
Yrs. 


10 
Yrs. 


11 

Yrs. 


12 
Yrs. 


13 
Yrs. 


14 
Yrs. 


15 
Yrs. 


16 
Yrs. 


17 
Yrs. 


18 
Yrs. 


39 c 

40 ■ 

41 I 

42 t 

43 t 

44 / 

45 i 

46 t 

47 . 

48 . 

49 . 

50 . 

51 . 

52 . 

53 . 


54 35 

56 37 

58 39 

10 41 

12 42 

14 45 

16 47 

18 48 

. 49 

. 51 

. 53 


36 
38 
40 
42 
43 
45 
47 
49 
50 
52 
54 
56 
59 
62 




































































43 
44 
46 
48 
50 
51 
53 
55 
57 
60 
63 
66 






























































49 
51 
52 
54 
56 
58 
61 
64 
67 






































53 
55 


















56 
















57 58 
















59 
62 
65 
68 


60 
63 
66 
68 


61 
64 
67 
69 

TO 






































70 
no 












r- A 

















HEIGHT and WEIGHT TABLE for BOYS 




ABOUT WHAT A BOY SHOULD GAIN 
EACH MONTH 

Age 

5 to 8 . . . . 6 oz. 

8 to 12 . . . . 8oz. 
12 to 14 . . . . 12 oz. 
14 to 16 . . . . 16 oz. 
16 to 18 . . . .8 oz. 

ABOUT WHAT A GIRL SHOULD GAIN 
EACH MONTH 

Age 

5 to 8 # . . . 6 oz. 

8 to 11 . . . 8oz. 
11 to 14 . . . . 12 oz. 
14 to 16 . . . . 8oz. 
16 to 18 . . . . 4oz. 

Try and do as much better than the average 
as you can 

DEPARTMENT OF THE INTERIOR 
BUREAU OF EDUCATION 


HEIGHT and WEIGHT TABLE for GIRLS 


Hgt: 
Ins: 


5 
frs. 


6 

frs. 


7 
Yrs. 


8 

Yrs. 


Yrs. 


10 
Yrs. 


11 
Yrs. 


12 
Yrs. 


13 
Yrs. 


14 

Yrs. 


15 

Yrs. 


16 

Yrs. 


17 

Yrs. 


18 

Yrs. 


Hgt 


5 

Yrs 


6 
Yrs 


7 
Yrs 


8 

Yrs 


9 

Yrs 


10 

Yrs 


11 

Yrs 


12 
Yrs 


13 

Yrs 


14 

Yrs. 


15 

Yr 


16 

. Yrs 


17 18 
Yrs. Yrs. 


39 
40 
41 
42 
43 
44 
45 
46 
47 
48 
49 
50 
51 
52 
53 
54 
55 
56 
57 
58 
59 
60 
61 
62 
63 
64 
65 
66 
67 
68 
69 
70 
71 
72 
73 
74 
75 
76 


35 
37 
39 
41 

43 
45 
47 
48 


36 
38 
40 
42 
44 
46 
47 
49 
51 
53 
55 


37 
39 
41 
43 
45 
46 
48 
50 
52 
54 
56 
58 
60 
62 
























39 
40 
41 
42 
43 
44 
45 
46 
47 
48 
49 
50 
51 
52 
53 
54 
55 
56 
57 
58 
59 
60 
61 
62 
63 
64 
65 
66 
67 
68 
69 
70 
71 
72 


34 

3( 
38 
40 
42 
44 
46 
48 


3E 
3 r 
3£ 

41 
42 
4£ 
47 
48 
49 
51 
53 


3( 
3* 

4C 
42 
4C 
4£ 
47 
4£ 
5C 
52 
54 
56 
59 
62 






































































































44 
46 
47 
48 
50 
52 
55 
57 
59 
61 
63 
66 
69 






















43 
44 
4( 
48 
5( 
51 
53 
55 
57 
60 
63 
66 
68 
































































































49 
51 
53 

55 
58 

60 
62 
64 
67 

70 
73 

77 




















4i 

51 

52 
54 
56 
58 
61 
64 
67 
69 
72 
76 




















































54 
56 
58 
60 
63 
65 
68 
71 
74 
78 
81 
84 
87 
91 


















53 
55 
















57 

59 
61 
64 
67 
69 
72 
75 
79 
82 
85 
88 
92 
95 
100 
105 
















Sh 




























57 58 














62 
65 
68 
70 
73 
76 
80 
83 
86 
89 
93 
97 
102 
107 
113 














59 
62 
65 
68 
70 
73 
77 
81 
85 
89 


60 
63 
66 
68 
71 
74 
78 
82 
86 
90 
94 
99 
104 
109 


61 

64 

67 

69 

72 

75 

79 

83 

87 

91 

95 

101 

106 

111 

115 

117 

119 








































































71 
74 
77 
81 
84 
87 
90 
94 
99 
104 
109 
115 
120 
125 
130 
134 
138 
















70 

73 
76 
80 
84 
88 
93 
97 
102 
107 
112 
117 
119 
121 
124 
126 
29 














































78 

82 
85 
88 
92 
97 
102 
106 
111 
117 
122 
126 
131 
135 
139 
142 
147 
152 
157 
162 
















77 
81 
85 
89 
94 
99 
104 
109 
113 
118 
120 
L22 
L26 
L28 
L31 
34 
38 














































90 
94 
99 
104 
109 
114 
118 
123 
127 
132 
136 
140 
144 
149 
154 
159 
164 
169 
174 
















86 
90 
95 
100 
L06 
111 
115 
119 
122 
124 
127 
L30 
33 
36 
40 
45 
















91 

96 
101 
106 
111 
115 
119 
124 
128 
133 
137 
141 
145 
150 
155 
160 
165 
170 
175 
















91 
96 
102 
108 
113 
117 
120 
123 
126 
128 
132 
135 


98.'.'.' 
104106 
109111 
114115 
118119 
121122 
124125 
127128 
129130 
133134 
36 137 












102 

108 

117 
120 
125 
129 
134 
138 
142 
146 
151 
156 
161 
166 
171 
176 


no 

116 
119 
122 
126 
130 
135 
139 
143 
147 
152 
157 
162 
167 
172 
177 






















































































































































































































































































































38139140 
42143144 
47148149 


































































■ 




























































Prepared by Dr. Thomas D. Wood 






























































Prepared by Dr. Thomas D. Wood 










Height and weight to be taken in house clothes without shoes. Weigh on the same day each month. Age the nearest ■birthday. 
Each child to enter his own weight. 



FOOD AND DIET 91 

that foods are composed of various substances called 
nutrients, which may be classified as (a) carbohydrates 
(starches and sugars), (b) fats and oils, (c) proteins, 
(d) mineral substances, and (e) water. To the nu- 
trients should be added fibrous material and vitamines. 
Not all foods are composed of these substances in the 
same proportion. A glance at the figures prepared by 
the United States Department of Agriculture will 
make this clear. From the foods given in the chart 
shown on pages 92 to 97 inclusive select two that 
are especially rich in carbohydrates ; two that are espe- 
cially rich in fats; two that are especially rich in pro- 
tein, and two that are especially rich in mineral matter 
or ash. 

38. Overweight and under weight. The question 
of overweight for men and women of thirty-five years 
and over is an important one. The Life Extension In- 
stitute of New York says, " after the age of 35, over- 
weight is associated with an increasingly high death 
rate, and at middle life, it becomes a real menace to 
health, either by reason of its mere presence as a physi- 
cal handicap or because of the faulty living habits that 
are often responsible for its development. If there is 
a family tendency to overweight, one should begin early 
to form habits that will check this tendency. If con- 
siderable overweight is already present, caution is nec- 
essary in bringing about a reduction. Barring actual 
disease, this can usually be done without drugs if the 
person will be persevering and faithful to a certain 
regime." 

With boys and girls under 20 years of age, over- 



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98 HEALTH AND EFFICIENCY 

weight does not usually have this significance. If a 
reduction of weight is desirable, this can be accom- 
plished by exercise and dieting. Carbohydrate foods 
must be avoided although not excluded altogether, and 
in their place such fibrous foods as bran cereal, turnips, 
cabbage, and spinach should be used. Candies and des- 
serts are especially to be avoided. 

The greatest danger with children at the present time 
is that there will be a lack of nourishment with conse- 
quent under weight. As a rule, spare children will put 
on weight if a proper diet is followed. This should 
include cooked cereals, milk, and eggs. In a later sec- 
tion of the book some suggestions will be given as to 
the choice of nutritious but inexpensive foods. One 
of these is milk, the nutritive value of a quart of which 
is estimated to be equal to that of a pound of beef. 

39. Temperance in eating and drinking. In the 
Boy Scouts' Handbook, Dr. George J. Fisher says, 
" The average boy ought to have and usually does have 
an appetite like an ostrich. Three points to remember 
are: don't eat too much, most healthy boys do; don't 
eat meat more than once a day ; and third, don't eat 
anything that you always taste for several hours after 
you have eaten it, even though you like it." In regard 
to the use of stimulants, Dr. Fisher says : " Should a 
boy drink cofifee or tea? This is a question often asked 
by boys. Coffee and tea are the greatest stimulants 
known. But does a strong boy need a stimulant? 
What is a stimulant and what does it do ? A stimulant 
is a whip, making the body do more at a given time 
than it ordinarily would. It doesn't add any fiber to 



FOOD AND DIET 



99 



the tissues, doesn't add any strength, isn't a food, but 
merely gets more out of the tissues or nervous system 
than they would ordinarily yield. Of course there is a 
reaction, because the tissues have had nothing to feed 
on. Herbert Fisher says that Peary's men, who drank 
lots of tea on their voyage north, during the most try- 
ing time of their trip, showed it in their haggard faces 




Copyright by Underwood & Underwood 

Fig. 45. — Domestic science expert lectures at the Old 
Dutch Market in Washington 

and loss of tissue. Their own tissues had turned can- 
nibal and fed on their own material. Stimulants are 
not foods. They add no strength to the body. They 
exact of the body what ought not be exacted of it. 
There is always a reaction and one is always worse off 
as a result. Growing boys especially should have noth- 
ing to do with tea, coffee, or any other stimulant." In 
this connection it should be unnecessary to say that 



100 HEALTH AND EFFICIENCY 

tobacco and alcohol should not be used by the growing 
boy or girl. Alcohol may have a distinct value in medi- 
cine when prescribed by an experienced physician but 
it certainly should not be used as a beverage. Alcohol 
depresses the intellectual functions of judgment and 
reasoning power. Tobacco should be excluded during 
the period of growth as rigidly as alcohol. Both are 
narcotic poisons; they interfere with growth, with the 
nourishment of the body and with the work of the 
brain and heart. If a young man will wait until he is 
21 years or over, his judgment will be more mature and 
he will think twice before becoming addicted to any of 
these drugs. 

40. Regularity of meals. Growing boys and girls 
frequently pay little or no attention to regularity in 
eating or' to the quantity of food consumed. Candies, 
cakes, and ice cream are eaten between meals, and chil- 
dren excuse themselves on the ground that "they do 
not count. ,, As a matter of fact, such foods have a 
very high fuel value for the body and may displace from 
the diet a food which the body needs. Pickles, frank- 
furters, soda water, and candies, which are so fre- 
quently used to fill in between meals, should be omitted 
from the diet and eating confined to three meals taken 
at regular times. 

41. Idiosyncracy. We have all heard it said that 
" such and such a food does not agree with me." That 
person is said to have an idiosyncracy for that food, 
meaning that for some unknown reason the protoplasm 
of his body will not tolerate some substance contained 
in the specified food. G. G. Fisher, M.D., Secretary, 



FOOD AND DIET 



101 



Physical Department International Committee Y. M. 
C. A., an athletic instructor of experience, says: 
M Some persons cannot digest onions ; others thrive on 
them. Some can't eat cucumbers, others can do so 
readily. The one must give them up; the other can 
continue to eat them. Each person has some peculiarity 
of diet and must observe it to be happy. Many a race 
has been lost through failure to obey this rule." To 
some persons mutton is a poison; with others straw- 




Fig. 46. — Inspecting milk 

berries and shellfish, and with others, sugar foods. 
The author knows one lady to whom butter is a pow- 
erful poison, the odor of it producing intense nausea. 
It is difficult, therefore, to standardize diet. Each one 
must study his own case and omit from his diet any 
foods for which he has an idiosyncracy. 

42. Vegetarianism. True vegetarianism is rare be- 
cause most vegetarians use milk, cheese, and eggs, 
which are true animal foods. It is probably true that 



102 HEALTH AND EFFICIENCY 

many persons could profit by a closer adherence to a 
vegetable diet ; it is also probably equally true that for 
others to attempt a vegetable diet would be little short 
of suicide. Women require less food than men; grow- 
ing children, more than adults ; both require more in 
winter than in summer; and those who labor out of 
doors require more than those who labor indoors. A 
purely vegetable diet becomes monotonous for most 
persons and, since so much of the vegetable food is fi- 




Photograph from Underwood & Underwood 

Fig. 47. — A fine growth of sugar cane on a Louisiana 
plantation 

ber, a very large quantity must be consumed. Vege- 
tarians have, however, shown the value of their diet 
and most persons can eat with profit more vegetables 
and less meat. It should be noted in speaking of this, 
that meat has a stimulating effect in the body and 
those who are going through periods of physical or 
mental strain will find it well to partake liberally of 
such meats ?.s beef or mutton. 



FOOD AND DIET 103 

43. Desirable articles of diet. From time to time 
attention has been called to foods which should be in- 
cluded in most dietaries. It is well to summarize and 
classify the information here. Among tissue building 
foods are to be noted whole wheat bread, milk, eggs, 
cream cheese, beans, peas, cereals and corn meal ; 
among heat and fat producers are olive oil, oleomar- 
garine, nuts, and fat meat, like bacon ; among energy 
producers are honey (liquid or comb), maple syrup 
and sugar (pure), and brown, unrefined, cane sugar; 
among the regulators are greens (such as spinach, dan- 
delions, and beet tops), whole wheat or bran flour, 
onions, radishes, raisins, dates, figs, oranges, and apples. 
Canned goods should be avoided, and frequent visits to 
vegetable stores will serve to stimulate a taste for this 
very important part of a diet. 

44. A study of personal dietaries. Since the broad 
principles of hygienic eating have been laid down in the 
preceding paragraphs, it is possible at this point to 
make an inventory of each personal diet. The follow- 
ing preliminary questions should first be answered : 

a. Do you confine your eating to three nieals a day? 

If not, what do you eat between meals? 

b. Do you use tea or cofTee? If so, how many cups 

a day? 

c. Do you chew food until it liquifies in the mouth ? 

d. Do fresh or freshly cooked vegetables form a part 

of at least one meal each day? 

e. Do you use graham, whole wheat, or bran bread 

at least a part of the time? 

f. How often do you use fresh, ripe fruit? 



104 HEALTH AND EFFICIENCY 

g. Do you have a cooked cereal like oatmeal, hominy, 
or Petti John for breakfast at least in the winter 
months ? 

h. Do you have at least one glass of fresh milk each 
day and fresh eggs at least twice a week ? 

The question now arises as to whether your food is 
meeting the fuel needs of your body. The amount of 
fuel which the body can burn is limited, and fuel con- 
sumed in excess of this amount is stored as fat or ex- 
creted unused. Fuel, less in amount than required, 
leads to a loss of vitality. How can we measure the 
amount of fuel the body needs and how can we measure 
the amount supplied ? This has been done many times 
by scientists in America as well as Europe and con- 
sists in having individuals live in a specially constructed 
room called a calorimeter chamber. Chairs, a bed, and 
a tread machine for the purpose of doing and meas- 
uring work are provided. The food consumed is care- 
fully analyzed and weighed as well as the excreta from 
the body, and the rise in temperature is registered by 
thermometers. The unit of heat used by experimenters 
is that amount which will raise the temperature of iooo 
grams of water i° centigrade, and is called a large 
calorie, or simply a calorie. It is not necessary to 
burn food in the body to ascertain its calorie value, 
but simply to weigh a given portion, drive off its water 
by slow heating, and burn it. By the use of the calo- 
rimeter and by studying the diets of boys and girls 
who have exercised a free choice in making up their 
diets, the New York Association for Improving the 
Condition of the Poor has prepared the following table 



FOOD AND DIET 105 

showing the calorie requirement of boys and girls be- 
tween the ages of 12 and 16: 

Boys Girls 

From 12 to 13 2300-2700 1850-2150 

From 13 to 14 2500-2900 195CH-2250 

From 14 to 15 2600-3100 2050-2350 

From 15 to 16 2700-3300 2150-2450 

From 16 to 17 2700-3400 2250-2550 

It has been ascertained that the burning of an egg, 
or of two slices of white bread, or of % of a glass of 
milk, will yield 100 calories of heat. Using the chart 
given above as well as other charts which may be ob- 
tained from the United States Department of Agricul- 
ture and elsewhere, compute the total number of cal- 
ories of heat which the burning of the food consumed 
by you yesterday furnished your body. Does the re- 
sult approximate the standard for your age? 

45. The economic aspect. It comes as a shock to 
many persons to know that the highest priced foods are 
not necessarily the most nutritious, and that of two 
equally nutritious foods, one may be three times the 
cost of the other. Thus, sirloin steak costs half again 
as much as round, and yet a pound of round steak fur- 
nishes the body with more protein, fat, and heat than a 
pound of sirloin does. In like manner, cheese costs 
less than most meats but furnishes at least as much 
nutrition ; oleomargarine is practically the same in 
chemical composition as butter and costs much less ; a 
tablespoon of honey, or pure maple syrup, or brown 
sugar costs much less than one portion of dessert, but 



106 



HEALTH AND EFFICIENCY 



furnishes as much fuel value and is much easier for 
the body to utilize. 

A very interesting experiment along this line was 
conducted recently by the New York City Police De- 
partment and the Life Extension Institute. The de- 
tailed report of the experiment is given in a pamphlet 
called " Food," published by the Life Extension Insti- 
tute, 25 W. 45th St., New York. The pamphlet gives, 




Photograph from Underwood & Underwood 

Fig. 48. — A public school class in cooking 

in addition to the report on the experiment, some very 
valuable menus and recipes which provide for an in- 
expensive but nutritious diet. The subjects of the ex- 
periment were twelve policemen ranging in ages from 
25 to 31. The group was placed on a diet providing 
little meat and costing about 25 cents a day. During 
the three weeks of the experiment, the group gained 
on an average 3 pounds for each man, and their blood 
pressure, which was a little high, returned to normal. 



FOOD AND DIET 



107 



46. Utilization of scraps. Since vitamines are pres- 
ent in the skins and leaves of certain vegetables and in 
fruits and cereals, it is a mistake not to use these parts 
wherever possible. One of our commonest dietetic 
errors consists in not using the chaff or outer coating 
of grains. It is full of valuable mineral substances 
which are needed by the body and without which the 
body cannot function properly. Phosphorus, for in- 



Kijiim 




^^LomyA IB 






\x 


/^ftV^Lj^TK ^H 




\ 


1 Mm 


~ ' . 




Hi r 



Copyright by Underwood & Underwood 

Fig. 49. — A lesson in economic buying 

stance, which is so much needed, is present in the outer 
coat of grain. Wheat chaff can be bought as bran and 
can be mixed with white flour to make bread or can be 
mixed with cereals like oatmeal for a breakfast dish. 
Another common dietetic error consists in peeling ap- 
ples and potatoes. Unless a person is distressed by 
eating the skin of the apple, the fruit should be used as 
it comes from the tree. The same advice applies to po- 
tatoes. The skin of a boiled or baked potato assists in 



108 HEALTH AND EFFICIENCY 

regulating the function of the bowels and, in addition, 
supplies valuable mineral substances. Even the water 
in which potatoes, turnips, carrots, and some other vege- 
tables are boiled should be saved, as a very nutritious 
soup can be made from it by adding a bone, a few pieces 
of large macaroni and, if desired, a small piece of beef 
or mutton. The tops of beets are rich in iron and 
when boiled make a delicious dish of " greens." Dan- 
delions and milkweed, when picked in the spring, may 
be used for the same purpose. Pieces of stale bread 
will improve the condition of the mouth and an excel- 
lent pudding can be made from them. Pieces of fat 
should be " tried out " for shortening. The bones of 
beef and mutton should never be left at the butcher's 
but should be used in the preparation of soup, as the 
marrow and the surface of the bone contain ingredients 
needed by the body. 



CHAPTER VI 

THE CARE OF THE MOUTH, NOSE, THROAT, 
AND THE ORGANS OF SPEECH 

47. The Mouth and Nose as germ gardens. Since 
bacteria are plants, they can be grown, and it is pos- 
sible to have a germ garden, just as one can have a 
garden of flowers or vegetables. Bacteria grow well 
in milk or gelatine, or on raw potato, or in beef broth, 
or on a gelatinous mass called agar, made from a sea- 
weed found off the coast of Japan. Any one of these 
substances can be placed in a test tube or in a flat glass 
dish called a petri dish, and bacteria will, under certain 
conditions, grow in them. 

One of the best places to grow bacteria is in a 
sterile tube partly filled with sterile agar. If your 
school is not supplied with agar tubes a few may usu- 
ally be borrowed from a College or University Depart- 
ment of Bacteriology or from a Department of Health 
(City or State). When we speak of a sterile object 
we mean one which contains no form of germ life. 
Experiment. Rub the tip of a needle, made sterile by 
boiling, over the front teeth two or three times and then 
make a scratch on the surface of the agar. Stopper 
the test tube with a plug of cotton made sterile 
by drawing it through a flame. Put the test tube in 

109 






110 



HEALTH AND EFFICIENCY 



a dark place where the temperature will be about 8o° 
F. In two or three days you will notice a change 
in the agar. The narrow incision on the surface 
made by the needle has been replaced by a broad 
band running down into the incision and also back 
from the sides.. What color is it? This broad band 
has been made by bacteria multiplying so rapidly and 
growing so closely together that they form one continu- 




Fig. 50. — The teeth should be examined at least every 
six months 

ous mass. It is said that 400,000,000 bacteria, if packed 
together, would form a mass no larger than a grain of 
sugar. It would be difficult to estimate the number 
that you have raised in your garden in a few hours. 
They came from the teeth and you can see from this 
experiment how important it is to brush the teeth and 
to sterilize the brush after using. 

Bacteria are present in the nose and throat as well as 



MOUTH, NOSE AND THROAT 111 

on the teeth. Most of them are harmless germs, i. e., 
they do not produce disease in the human body. Some, 
however, are capable of prodcing disease and others 
decay particles of food that may be left on the teeth. 
The mouth is an almost ideal germ garden, since the 
temperature, the moisture, and food are all favorable to 
their growth. Inasmuch as bacteria producing such 
diseases as tuberculosis, diphtheria, colds, and grippe 
may be present in the mouth, nose, and throat, these 
parts of the body should be kept as clean as possible. 
This can be done by brushing the teeth frequently, 
gargling the throat with water, and using a handker- 
chief to assist in clearing out the nose. Some phy- 
sicians recommend the use of a nasal douche — the 
flushing of the nose with a liquid — but others of equal 
experience advise against the practice because of the 
danger of injuring the tiny tubes leading from the 
throat to the middle ear. It is recognized by all phy- 
sicians that the nose and mouth are the two most im- 
portant portals for the entrance of disease bacteria into 
the body. 

48. Structure, diseases, and care of the teeth. The 
teeth are apparently so hard and set so firmly in the 
jaw that it would not seem possible to injure them. 
Yet under modern conditions of living they stain easily, 
decay easily, loosen easily, and finally drop out of their 
sockets long before their period of usefulness has ex- 
pired. Why is this? Partly because of a decrease in 
the amount of fruit eaten, partly because of a decrease 
in the amount of hard and bulky food, and partly be- 
cause of a generally decreased vitality due to our mod- 



112 HEALTH AND EFFICIENCY 

ern housing and working conditions. Is there any way 
to remedy these conditions so that we may have the 
hard white teeth that our grandparents had? Fortu- 
nately there is, and if the method of correction is fol- 
lowed, especially by young boys and girls, it will result 
in better teeth and better health generally. 

If you rub the tip of the tongue over the teeth 
you will notice that the teeth are covered with a slimy 
substance like a thin mucilage. It is this that is respon- 
sible for much of the trouble that comes to our teeth. 
In the first place, food particles stick to it, then decom- 
pose with the formation of acids, causing the decay of 
the teeth ; secondly, this slimy substance allows mineral 
substances to be deposited on the teeth, forming " tar- 
tar " ; and thirdly, germs, gaining a foothold on the 
tartar, work their way down between the tooth and the 
gum, producing disease. Probably every one has 
noticed that the teeth feel cleaner and harder 
after fruit has been eaten. This is because the acids in 
the fruit remove the slimy covering of the teeth. Such 
fruits as apples, grapefruit, lemons, and oranges should 
be included in every diet. Another way of removing 
the slime from the teeth is by eating whole wheat bread 
or bran bread or crusts of any kind of bread. The 
chewing of hard and bulky foods requires more muscle 
work than does the chewing of soft foods like 
white bread and pastry and, as a consequence, the 
circulation in the jaw is improved. Furthermore, the 
particles of solid material in bran and whole wheat 
bread act like so many little tooth brushes, rubbing up 
and down over the teeth, removing the slime and min- 



MOUTH, NOSE AND THROAT 



113 



eral deposits, and leaving the teeth hard and clean. 
The teeth, as well as the bones, are made up largely 
of compounds of calcium; consequently foods contain- 
ing large amounts of this substance should be eaten. 
Such foods are whole wheat bread, milk, and eggs. 




Fig. 51. — Dental chart 

Dental examination. It will be well at this point to 
conduct a dental examination. First make a copy of 
Fig. 51 on a card 6" x 8", putting your name at the top. 
Now exchange Dental Charts with a pupil sitting next 
to you. Ask him to press his upper lip upward with 
the tips of his little fingers so that you can see the 
upper front teeth. Are they of a pearly white color or 
are they deeply stained with a dark brown, black, or 
greenish deposit? If they are stained, write S in the 



114 HEALTH AND EFFICIENCY 

upper right hand corner of the Dental Chart. Now 
ask the pupil to pull down the lower lip with the tips 
of the fingers and examine for stain. If there is much 
stain present and the gums are drawn down from the 
base of the tooth and whitish or yellowish matter col- 
lects when the gum is pressed against the tooth write 
a second S on the chart. Be careful not to put 
your finger, pencil, or other object into the mouth of 
the other person at any time during the examination, as 
bacteria may be transferred in this way. Now ask the 
pupil to open his mouth and to pull back the comers 
with the little fingers so that you can see the back teeth. 
Can you see any cavities in the teeth? Are any teeth 
missing? If so, have they been extracted or have they 
decayed down to the roots? If you find cavities or 
decayed teeth place a check next to the proper tooth 
on the Dental Chart. If you think that further ex- 
planation concerning the condition of the mouth should 
be given, put it at the bottom of the chart. When 
this part of the examination is finished, exchange cards 
and allow the other pupil to examine your mouth. 
When the examination is complete, hand the Dental 
Charts to your teacher so that he may advise you what 
to do. 

A decayed tooth is not only an inconvenience, making 
it difficult to chew food and producing a foul breath, 
but it may be the means of disease germs getting into 
the blood stream of the gum and being later transported 
to other parts of the body. So true is this that many 
physicians of experience are of the opinion that these 
germs are deposited in the joints, producing rheuma- 



MOUTH, NOSE AND THROAT 115 

tism, and on the valves of the heart, producing a 
'* leaky " heart. Nature's method of cleaning the teeth 
by means of coarse foods and fruit juices has been indi- 
cated. We can, moreover, aid Nature by using a tooth 
brush. The teeth should be brushed thoroughly at 
morning and at night. Most persons brush the teeth 
too fast. It should be done slowly, with a brush drip- 
ping with water, and the brush should be pressed into 
the crevices between the teeth. While there are many 
tooth powders, liquids, and pastes available, it is well to 
use occasionally one of the fruit acids such as pure 
vinegar or lemon juice, in the proportion of one part of 
fruit juice to two parts of water. After the fruit 
juices have been used, the teeth should be rinsed well 
.with water. This can be done best by holding some 
water in the mouth and forcing it between the teeth by 
compressing and relaxing the cheeks. 

Dentists should be called on to do more than to cor- 
rect defects of the teeth. Every person should go to a 
dentist at least every six months for a dental examina- 
tion. By following this advice slight defects can be 
remedied at an early period. Finally, students should 
be advised concerning the assistance that dentists can 
give by remedying defects of the jaw like projecting 
teeth, crowded teeth, and misshapen jaws. The art of 
Dentistry has proceeded so far that most of these con- 
ditions can be remedied and many persons saved much 
inconvenience and embarrassment. 

Summary, i. Your teeth form the cutting and 
grinding machine which prepares food for the stomach. 
When this machine is crippled by tooth decay, you 



116 



HEALTH AND EFFICIENCY 



suffer from toothache, indigestion, and many bodily 
disturbances which are the result of disease germs being 
carried from the teeth to other parts of the body. 

2. The decay of teeth is due to acids formed by the 
decomposition of food between or on the surface of 
the teeth. 

3. To prevent decay of the teeth, chew the food thor- 
oughly : pass r.oss silk or silk thread between the teeth 




Tvbe to eor Nocked. 

pwollen toriail 



Se cob .-. tonsils from 

which adenoicU qrour 

Jonsil 
7c rw u e 



yo stcrr.cch 
To hu^f 

Fig. 52. — Showing how enlarged adenoids and tonsils 
interfere with hearing and breathing 

after meals : carefully and thoroughly brush the teeth 
with a good tooth brush, on arising in the morning, 
after each meal, and on retiring at night. 

49. The care of the nose. The nose is frequently 
the seat of obstructions and abrasions. Obstructions 
occur when the mucous cakes or when bones grow into 
the nasal cavity, or when tiny hair-like structures called 
polyps grow from the mucous epithelium into the nasal 
cavity, or when glandular growths called adenoids form 
in the back of the nose. Any obstruction of the nasal 
passage should be remedied, as it may produce mouth 
breathing. The nose allords normal passage for the 
air to the lungs. It is provided with an air filter in the 



MOUTH, NOSE AND THROAT 117 

form of hairs ; its sides are smeared with sticky mucous 
to which solid particles may adhere, and it is lined with 
countless blood' vessels which warm the air and thus 
prepare it for the lungs. It is essential that a handker- 
chief should always be at hand so that the nostrils may 
be cleared frequently. In attempting to clear the nose 
too much force should not be exerted as it is easily pos- 
sible to rupture the ear drums. This is particularly 
true when one nostril is held closed. Failure to an- 
swer this call of Nature may cause the mucous to cake 
and drop into the throat and finally into the stomach. 
If the mucous cakes in spite of all precautions, the nose 
may be flushed with warm salt water (one teaspoonful 
of salt to a bowl of luke warm water). This can best 
be done by pouring the water into the palm of the hand 
and sniffing it into the nose and down to the throat. 
This should not be done continually, for if the condition 
does not improve, a physician should be consulted. 
Bony projections into the nose may block the passage- 
way for air, produce a nasal tone in the voice, and inter- 
fere with sleep. This condition can be remedied by a 
slight operation. 

Warning should be given at this point against the 
practice of picking the nose. Any tear in the mem- 
brane of the nose gives a point of entrance for disease 
bacteria and blood poisoning may result. A case in 
point is that of a prominent young physician of New 
York who was called out of the city recently as a con- 
sultant. During the journey, being irritated by a hair 
projecting from his nostril, he pulled it out. The next 
day the nose was inflamed and sore. Poisoning had 



118 HEALTH AND EFFICIENCY 

set in which was carried to other parts of the body and 
death occurred a short time after. 

50. Adenoids and tonsils. The adenoids and tonsils 
are normal glands found in the throat and back part 
of the nasal passage. They probably have the same 
function, that of manufacturing white cells for the 
blood, and the adenoids are sometimes referred to as 
the second tonsils. Reference to Fig. 52 will show the 
position of these glands — the adenoids being higher 
up in the throat than the tonsils. Frequently these 
glands become diseased and enlarged, blocking the 
passageway from the nose to the throat, and from the 
mouth to the throat, causing difficult breathing, tender- 
ness in the throat, susceptibility to colds and certain 
important general symptoms. These general symp- 
toms are quite pronounced — drawn face, thick, parted 
lips, and partial deafness. Added to these symptoms 
are irritability, paleness, stupidity, and malnutrition. 
It is surprising to know that the inflammation of such 
small structures can produce such general body effects 
but that this is the case has been ascertained after a 
great deal of medical inspection in the schools. For- 
tunately, a comparatively slight operation will remove 
the cause and enable the body to get back to its normal 
condition. 

51. Our organs of speech. In the larynx, just 
above the upper end of the trachea or windpipe, 
are two fibrous bands called the vocal cords. Currents 
of air passing over these cause them to vibrate, some- 
what as the bow passing over the strings of a violin 
produces a vibration, and thereby a sound. Speech is 



MOUTH, NOSE AND THROAT 119 

produced by vocal cords, lips, teeth, tongue, and palate 
working together. Americans have been very careless 
in their habits of speech, making little or no study of 
speech sounds. The science of Phonetics is being 
studied in the more progressive schools now and is do- 
ing much to remedy the condition. 

Defects of speech are frequently caused by laziness, 
lack of vitality, fatigue, defective palate or teeth, and 
by nervousness. Most of the common defects can be 
corrected by a study of the laws of speech. Stammer- 
ing and stuttering cause not only embarrassment but di- 
minish one's earning capacity, as many opportunities to 
earn a livelihood are closed to those with speech de- 
fects. Emphasis should again be given to the oppor- 
tunity for correction. Most of the large cities now 
provide specialists in this work and access to them may 
usually be had even by those who live some distance 
away. There is little excuse, therefore, for persisting 
in a speech defect. 



CHAPTER VII 

DIGESTION, ABSORPTION, CIRCULATION, 

AND THE HYGIENE OF THE 

ALIMENTARY CANAL 

52. The preparation for digestion. A given amount 
of food carefully chewed will go farther toward the 
nutrition of the body than a larger amount hastily swal- 
lowed. This is particularly true of vegetable food, as 
the cells are enclosed by walls of w r ood. Herbivorous 
animals, like the rabbit and cow, chew r their food very 
thoroughly. Even meat should be thoroughly shredded 
in order that the digestive fluids may reach it. Diges- 
tion is carried on by liquids in the mouth, stomach, and 
intestine. These slowly liquify the solid food, so that 
it can be absorbed by the blood. The teeth are most 
useful in shredding the food but teeth are confined to 
the mouth. Some persons eat as though the stomach 
were provided with teeth. They bite off large mouth- 
fuls of food, swallow it hastily, and trust that it will 
be liquified later ! The continual presence of large, 
coarse masses in the stomach may produce pain, gas 
and inflammation. Completely chewed food means 
easy, thorough digestion, easy and thorough absorption, 
and, therefore, proper cell nutrition. Moreover, 
thorough mastication makes it unnecessary to use large 

120 



DIGESTION AND ABSORPTION 121 

quantities of liquid with the meal. A good rule is to 
chew the food until it has largely liquified in the mouth. 
In doing this, the starch will be partly digested by the 
saliva and the rest of the food will be prepared for 
digestion in the stomach and intestine. 

53. What happens to the food after it is swallowed. 
The food passes out of the mouth into the oesophagus, 
which is a muscular tube about a foot long leading into 
the stomach. During the act of swallowing, the bands 
of muscle in the oesophagus contract, starting at the 
top, and force the food into the stomach, where di- 
gestion continues to a limited extent. Most persons 
think that all digestion occurs in the stomach. Such, 
however, is not the case, for digestion of food goes on 
even when the stomach is removed, as is sometimes 
done in cases of cancer. The principal function of the 
stomach is to churn the food and to reduce it to its 
proper consistency. This organ is an irregular, pear- 
shaped pouch, with a capacity of about three pints. 
The walls are in part made of muscle, some of which 
run transversely, some longitudinally, and some diag- 
onally. After a meal these contract, churning the food, 
reducing its consistency, and forcing it finally into a 
long coiled tube known as the small intestine. Just as 
some starch digestion goes on in the mouth, so some 
protein digestion goes on in the stomach. In the walls 
of the stomach are thousands of tiny glands, some se- 
creting an acid (hydrochloric) and some secreting a 
digestive ferment, or enzyme (pepsin). When food 
is in the stomach, it is mixed with these substances and 
some of the protein portion is liquefied. Digestion 



122 HEALTH AND EFFICIENCY 

here, as well as digestion in the mouth, relieves glands 
farther along in the digestive canal. Although the ca- 
pacity of the stomach is normally three pints, it can be 
overloaded and stretched. This is the case with those 
who consume large quantities of drink or food. A 
distended and misshapen stomach is frequently the 
source of a great deal of illness. It can be avoided by 
slow eating and drinking and by temperance in both. 

54. The small intestine. Diagrams like Fig. 2 
cannot show the true length of the small intestine, for 

. -van 

Openings of\Gland>" 
Intestinal Glands. J 

Fig- 53- — Mucous membrane of small intestine 

to depict it accurately would occupy too much space. 
It is about twenty-two feet long and lies coiled in the 
abdomen. In this tube digestion is completed. Into 
it are poured bile from the liver, pancreatic juice from 
the pancreas, and other digestive fluids from glands in 
its wall. 

Bile, secreted by the liver, collects in the gall bladder 
or bile sac, and is, on occasion, poured into the intes- 
tine. It is partly a waste product, being made up of 
worn out blood corpuscles and other wastes, and partly 
a digestive fluid, facilitating the passage of fats into 




DIGESTION AND ABSORPTION 123 

the blood. Conditions described as sluggishness of the 
liver and biliousness are common. They are charac- 
terized by a feeling of irritability, grouchiness, indis- 
position, constipation, and lack of the usual relish for 
food. They can usually be corrected by exercise and 
diet. Any general exercise like walking and swimming 
is valuable but should be supplemented by special cor- 
rective exercises that call for action on the part of the 
abdominal muscles. Special exercise of this sort is 
obtained by standing erect, hands on hips, and bending 
first to one side, then to the other ; this should be fol- 
lowed by bending forward and backward and by twist- 
ing the abdomen on the hips while keeping the legs rigid. 
This exercise should be varied by lying on the back and 
raising the body and the legs alternately from the floor. 
A corrective diet for the symptoms indicated above 
should include fruit, marmalade, and fibrous vegetables 
like turnip, spinach, dandelions, and cabbage (fresh or 
as sauerkraut). This diet should be supplemented by 
drinking large quantities of water. In some acute 
cases a cathartic is needed and, if so, it had better be 
epsom salts, cascara, or castor oil, rather than 
a patented preparation whose composition is obscure. 

The pancreatic juice, secreted by the pancreas, con- 
tains enzymes which digest proteins, oils, and starch. 
In cases of an unbalanced diet, or of overeating, or of 
hasty eating, some food will pass on undigested even 
after the combined action of saliva, gastric juice, bile, 
and pancreatic juice. Of course, there is always the 
fibrous content of the food that cannot be digested by 
any of these fluids. Besides this, there is the residuum 



124 



HEALTH AND EFFICIENCY 



of foods which is capable of being digested but which 
has gone on undigested. This latter is frequently the 
source of much disease. If it is not quickly expelled, 
it is apt to be attacked, in the large intestine, by bac- 
teria producing poisonous substances which are ab- 



Spilheli 



Intestinal gland 




lacteal 



Fig. 54. — Diagram showing how the blood circulates 
through the villi 

sorbed by the blood and distributed over the body. 
Many headaches and so-called " bilious attacks " are 
due to this cause. This condition of seli-poisoning is 
common and is responsible for many serious diseases ; 
it emphasizes again the need for careful attention to 
diet, with the inclusion of liberal quantities of fruit and 



DIGESTION AND ABSORPTION 125 

vegetables, the need for exercise, and for plenty of 
water. Water helps to prevent constipation. 

55. How is food absorbed from the small intes- 
tine? On the interior surface of the small intestine are 
so many tiny projections that it looks somewhat like 
velvet. Each of these is a food absorbing structure, 
known as a villus. Fig. 54 shows that each villus 
is covered with a sheet of cuboidal cells. These have 
the power of absorbing needed food materials, which, 
in case they are mineral matters or digested proteins 
or starches, are passed on to the blood vessels ; or, in 
case they are digested fats, they are passed on to the 
lacteals. Food materials going into the lacteals are 
later emptied into the blood stream. 

56. What is blood? Most persons know that blood 
is a red, thickish liquid, but few persons know that it is 
continually being made and discarded by the body. 
Much of it is water and much is digested food. Some 
of it is solid, some liquid, and some gaseous. The 
gaseous part is oxygen, breathed in from the air, and 
carbon dioxide, formed by burning food substances in 
the tissues ; the solid part is made up of red cells, carry- 
ing their loads of oxygen or carbon dioxide, and white 
cells, seeking disease bacteria to devour ; the liquid part 
is largely dissolved food substances. The red cells, 
which are so necessary to the life of the tissues, are 
made in the marrow of the bone, and the white cells are 
probably made in the spleen, bone marrow, and in such 
glands as the tonsil and adenoid. Red blood can be 
acquired by eating nutritious foods — cereals, vege- 
tables, fruit, milk, eggs and whole wheat bread ; by ex- 



126 HEALTH AND EFFICIENCY 

ercising out of doors ; and by securing mental poise by 
means of recreation and sleep. All of these are es- 
sential and the omission of any one interferes with the 
process of blood making. 

Advertisements for so-called ik blood making " medi- 
cines emphasize the fact that iron is an essential part of 
the blood. So it is, but unless prescribed by a phy- 
sician, patent medicines advertised to contain iron 
should not be used, but rather such iron-rich foods as 
spinach, string beans, dandelions, carrots, raisins, and 
cabbages. All of these contain iron in abundance and 
in a form easily assimilated by the tissues. 

57. Other parts of the body influencing nutrition 
and growth. The condition of the nervous system has 
a very important effect on the nutrition of the body. 
Consequently, it is well to surround a meal with con- 
siderable ceremony. Moreover, there are several glands 
in the body, called ductless glands, because they have 
no ducts to carry off their secretions. These empty di- 
rectly into the blood and are represented by the pituitary 
body at the base of the brain, regulating growth, and the 
thyroid gland situated at the front and sides of the 
neck, which has something to do with the nutrition of 
the body. The thyroid sometimes becomes enlarged, 
resulting in a condition called " goitre." At one time, 
these and other glands were thought to be useless struc- 
tures inherited from our animal ancestors, but now it is 
known that they are necessary to the life of the organ- 
ism. This should indicate to us that each part of the 
body is set aside for a certain function and that neglect 



DIGESTION AND ABSORPTION 127 

or abuse of any part may have a very serious effect on 
the rest of the body. 

58. The action of drugs on the heart and blood. 

The heart is a large muscle which contracts, on an aver- 
age, about seventy-two times a minute, forcing the 
blood throughout the body so that the tissues may be 
nourished and the w r aste products removed. One can 
get an idea of the work that the heart does in twenty- 
four hours, if he closes and opens his fist at one second 
intervals until the muscles of the hand are too tired 
to work more. The hand begins to tire in a few 
minutes, but the muscle of the heart keeps up its work, 
not only for minutes, or hours, or days, but for years. 
To do its work, it needs a well-toned nervous system, 
nutritious food, bodily exercise, and fresh, out-of- 
door air. The muscle of the heart needs care, 
but it frequently receives, instead, a bombardment of 
drugs, stimulating it to greater exertion or depressing 
its energies so that it is unable fully to do its work. 
Sometimes it is caffeine, at other times nicotine, and at 
other times alcohol. And yet some persons wonder 
why they suffer from palpitation of the heart, or from 
irregular beating, or from high blood pressure. 

Alcohol does not give greater strength to the body 
or mind but it simply stimulates the imagination so 
that a person thinks that he is gaining strength. Ex- 
periments with typesetters, typists, and with students 
have demonstrated beyond doubt that alcohol produces 
an increase in the number of errors and increases the 
time of production. Contrary to common opinion, al- 



128 



HEALTH AND EFFICIENCY 



cohol is, in the long run, not a stimulant but a narcotic. 
After absorption into the blood, it readily unites with 




Photograph from Underwood & Underwood 

Fig- 55- — Benjamin Franklin — an advocate of simple 

living 

oxygen, thereby depriving the tissues of this vitally 
needed element. Unless prescribed by a physician of 
experience, it should never be used. 



DIGESTION AND ABSORPTION 129 

Trainers of athletes know that tobacco lessens physi- 
cal efficiency. Cigarette smoking, in particular, is apt 
to produce anemia and to interfere with the nutrition 
of the body. 

Records such as those kept by Prof. Charles F. 
Emerson, Dean of Dartmouth College and a member 
of the class of 1868, indicate why many educators and 
physicians oppose the use of alcohol and tobacco. Dean 
Emerson was secretary of his class and, at the close of 
senior year, each member was asked to state whether 
he had used tobacco or liquor while in college. The 
replies were recorded at the time in a book kept by the 
secretary. About half of those who reported " yes " 
as to the use of liquor, qualified the statement by say- 
ing, " only light wine, ale, or beer," but they were 
classed with the users. In the following statistics, no 
account is taken of any qualification made by members 
of the class, nor of the personal habits of members since 
graduation. The secretary has kept an accurate record 
of the dates of death during the fifty years since gradu- 
ation, and the statistics are compiled from these data. 
The average age at death for those who passed away 
during the past 50 years is 44 years and 1 1 months for 
those who used liquor while in college, and is 63 years 
and 6 months for those who did not use liquor ; a differ- 
ence of 18 years and seven months in favor of non- 
users. During the first 25 years after graduation, 
29.4% of the users of liquor had died, while only 6.7% 
of the non-users had passed away. The average age 
at death for those who used tobacco in college is 49 
years and nine months, while for those who did not use 



130 HEALTH AND EFFICIENCY 

tobacco, it is 59 years and 4 months, or nearly 10 years 
in favor of the non-user. Similar records as those cited 
above obtained from six other class secretaries indi- 
cated similar results, although varying from 3 to 15 
years. The total records included observations on 500 
young men. 

The caffeine of tea and coffee, like alcohol and nico- 
tine, acts on the heart and, if used continually, may pro- 
duce severe derangement. All may lead to nervous- 
ness, digestive disturbances, and anemia. 

59. Patent medicines. When a house is out of 
order, a carpenter is called, and when the body is out 
of order, a physician should be called. The body de- 
serves the most skillful treatment that it can receive. 
Many communities now provide physicians to give 
needed medical treatment free of all charge to those 
who cannot afford to pay. These officials are men or 
women who have received a complete medical training 
and who have been licensed to practise medicine only 
after a thorough examination. The larger cities sup- 
port highly organized clinics and hospitals, where ex- 
pert medical and surgical treatment is given. 

In spite of this knowledge many persons use patent 
medicines. The New York State Department of 
Health, in a booklet entitled " Patent Medicines/' 
says: 

" What you get 

when you take a dose of a patent medicine. It is very 
much as though you took a teaspoonfull of the con- 
tents of a drug store slop pail. 



much as though you took a fc 
tents of a drug store slop pail. 



DIGESTION AND ABSORPTION 131 

Because all patent medicines contain only such 
drugs as may be got in any drug store, and any par- 
ticular patent medicine contains just so much of a 
few of these drugs in a combination no more suitable 
to your illness than any haphazard mixtures. 

Remember the label on a patent medicine bottle is 
intended to make as many readers of it as possible 
think it will do them good — to boost the sales. 

No one drug or combination of drugs is good for 
all diseases. 

Without medical advice you cannot tell what is 
the matter when you are sick. 

An example: Suppose you have a troublesome 
headache and take a guess as to the cause, see how 
easily you might miss the mark, as headache is very 
noticeable in all of the following conditions : 

Typhoid fever 

Pneumonia 

Also most infectious diseases of severe type, such 
as smallpox, at onset 

All forms of meningitis 

Malaria 

Anemia 

Heart disease 

Kidney disease 
etc., etc." 

Patent medicines are used because they contain stimu- 
lants, which may produce a feeling of well being for a 
time; or they contain purgatives, which often bring 
temporary relief ; or they contain " dope " which may 



132 HEALTH AND EFFICIENCY 

dull pain; or they contain an alkali, like baking soda, 
which neutralizes the acids formed by fermenting 
foods, and thus temporarily relieves stomach ache; or 
they contain a drug such as opium which may stop 
diarrhoea for a while." 

A fuller discussion of this subject can be found in 
" The Great American Fraud," by Samuel Hopkins 
Adams, which is issued by the American Medical Asso- 
ciation, 535 North Dearborn Street, Chicago. This 
association, which has been organized by the leading 
physicians of the United States and Canada, also pub- 
lishes a pamphlet, u Making the Right Start," which 
classifies and rates the medical schools of this country 
and shows their laboratory and clinical facilities. No 
prospective student of medicine should select a medical 
school without first consulting it. 

60. A study of the pulse. Turn the palm of the 
left hand upward and press the tips of the index and 
forefingers of the right hand gently on the thumb side of 
the wrist in a depression between a group of tendons 
which go to the fingers and the long bone which makes 
up the outer border of the forearm. A distinct throb 
occurs at regular intervals. This is the pulse. Count 
the number of throbs per minute while you are sitting 
quietly. Count them after running up and down 
stairs. What is the effect of exercise upon the pulse 
rate? The pulse is produced by the rhythmic dis- 
charge of blood from the heart into the arteries. It 
therefore shows the rhythm and rate at which the heart 
is beating, the pressure of blood within the arteries, 
and the elasticity of the walls of the arteries. 



DIGESTION AND ABSORPTION 



133 



61. Treatment of cuts and bruises. Even the 
slightest puncture of the skin should be washed with an 
antiseptic such as iodine. It is unsafe to rely on 
hydrogen peroxide as it is a weak antiseptic. 
Iodine is very reliable for general purposes. If the 
wound does not heal, but is inflamed and painful, the 
probability is that bacteria are present in the wound and 
a physician should be consulted. 




Fig. 56. — First Aid room in an automobile factory 



If the wound is deep so that the blood spurts out, 
pressure must be applied to prevent the person from 
bleeding to death. The pressure must be applied be- 
tween the wound and the heart as the spurting blood 
indicates that an artery has been cut. If the wound 
is in the arm or leg, a bandage put loosely about the 
part but tied with a strong knot and later twisted with 
a stick, will stop the flow of blood. Such a bandage is 



134 HEALTH AND EFFICIENCY 

called a tourniquet. Practise- making a tourniquet out 
of your handkerchief by tying it about the arm of an- 
other person. Remember that the circulation should 
not be shut off for over a half hour, unless necessary, 
otherwise, permanent injury may result. Remember, 
also, that the tourniquet should not be applied any 
tighter than is necessary. 

62. Irritations of the mouth. The lips frequently 
become chapped during the winter, causing considerable 
annoyance. In extreme cases, the lips crack and bleed 
freely. A simple and effective form of treatment con- 
sists in rubbing vaseline gently on the lips at night. 

Sore spots on the tongue or inside of the cheeks, 
called cankers, may be treated by rubbing a little 
powdered alum on them or by dissolving alum in warm 
water and washing the mouth with the liquid. If the 
spots do not heal consult a physician. 

The application of rouge to the lips is deceptive and 
harmful. It is deceptive because the redness of the lips 
should come from circulation of good blood and the 
person who paints pale lips removes a warning signal of 
ill health. It is harmful because of its irritating 
action on the tissues. It should be recalled here that 
the mouth is one part of the body where cancer is 
particularly apt to occur and that this disease seems 
to be frequently associated with such irritations as 
may be produced by hot liquids or the sharp edges of 
teeth. 



CHAPTER VIII 

THE HYGIENE OF THE SKIN AND THE 
USE OF CLOTHING 

63. What is perspiration? The skin is constantly 
giving off to the air or clothing a watery liquid with a 
salty taste. Sometimes this collects on the skin in drops 
but usually it evaporates into the air. One can assure 
himself that this liquid is being given off to the air by 
putting the hand into a cold, quart, fruit jar and then 
packing the mouth of the jar with cotton. A film of 
moisture soon collects on the sides of the jar. This is 
perspiration. It has been given off through the tiny 
pores of the skin, having been carried there by the blood 
which has collected it from the tissues. It is a part of 
the liquid waste formed by the burning of foods in the 
cells. In addition to salts and water, it contains car- 
bon dioxide and urea. It has much the same chemical 
composition as the liquid which is collected from the 
blood by the kidneys. One perspires most freely during 
or after exercise, since more foods are being burned to 
supply the muscles with energy. Free perspiration 
lightens the work of the kidneys, since it removes from 
the body poisonous wastes which would otherwise have 
to be removed by the kidneys. Failure to perspire 
freely can usually be corrected by drinking large quan- 
tities of water, by exercise, bathing, and diet. Bathing 

i35 



136 



HEALTH AND EFFICIENCY 



and a change of clothing are made necessary by the col- 
lection of perspiration on the skin. 

64. Hygiene of bathing, etc. The perspiration, oil, 
and dirt which collect on the skin can usually be re- 
moved by bathing in warm water containing soap. Any 
castile or toilet soap will do. Failure to bathe once or 
twice a week causes the body to have a disagreeable 




Fig. 57-- 



Photograph by Underwood & Underzcood 

■ A popular bathing resort — Coney Island, N. Y. 



odor. Warm baths, without the use of soap, draw the 
blood to the skin and thereby rest the nervous system 
and induce sleep. Warm baths are valuable when one 
is nervous or tired and produce a restful feeling 
much more completely than tea, coffee, or other stimu- 



HYGIENE OF THE SKIN 137 

lants. Cold baths drive the blood inward, producing 
exhilaration. They should be taken in the early part 
of the day and should leave one with a feeling of 
warmth. Cold baths should be followed by brisk rub- 
bing with a coarse towel. If they do not produce a 
feeling of warmth they should be avoided and in any 
case one should leave a cold bath before he begins to 
feel chilly. Hot towels should not be used in cold 
weather if one is going out of doors. On leaving a 
barber shop in cold weather it is well to turn up the 
coat collar if the hair has been trimmed, as the skin, 
under these circumstances, is quite sensitive. 

If the skin tends to chafe, talcum powder, cornstarch, 
or oxide of zinc can be applied after bathing. If the 
flesh is very tender, vaseline will tend to heal it. In 
the application of perfumes to the body or clothing, 
discrimination should be shown both in the quality and 
quantity. 

Oily skins can usually be improved by the reduction 
in the amount of sugary and oily foods and by an 
increase in the amount of fruits and fibrous vegetables. 

65. Eruptions of the skin. It is usual for boys and 
girls of fourteen or fifteen years to find that the skin 
becomes rough and even pimply. Attention to diet, 
the drinking of large quantities of water, use of fruits 
and vegetables, exercise and warm baths, will help to 
correct the condition. If the eruption is on the face, 
an examination should be made to find out whether the 
condition is caused by " blackheads " — conical masses 
of oil and dirt which form in the pores and irritate 
the surrounding tissues. They are frequently pres- 



138 HEALTH AND EFFICIENCY 

ent and may be removed by a " blackhead remover," 
which can be purchased at a drug store. After using 
the instrument, the skin should be bathed in listerine. 
Under no circumstances should the fingers be used 
to remove blackheads, because the fingernails easily 
tear the skin and a new infection may be started. 
Lemon juice taken as lemonade is said to have a very 
beneficial effect on the skin. 

In the case of boils it is best to apply a hot poultice 
first. If it breaks, the pus can be removed by gentle 
pressure from the sides, taking care to cover the 
fingers with a clean handkerchief or towel. An anti- 
septic such as iodine should then be applied. If the 
boil does not break it should be lanced by a 
physician. 

66. Care of the hair. Hair is an outgrowth of 
the skin and requires cleansing. It may be shampooed 
as often as once or twice a month, especially if dan- 
druff or excess oil is present. It is well to massage 
the scalp with the fingertips daily. If the hair is dry 
and brittle, olive oil will benefit it. Nothing is to be 
gained by the use of eggs as a shampoo. If dandruff 
is present it can be relieved by regulating the diet, 
rest, and by frequent shampoos. For this latter pur- 
pose castile soap will do. Wet the hair thoroughly 
with warm water and then rub the soap into it until 
a thick lather forms ; after this has been worked into 
the scalp, wash thoroughly with warm water and fin- 
ally with cold water. Twenty-five per cent, alco- 
hol, rubbed into the scalps once or twice a month, 
or a ten per cent, ointment of sulphur, used as fre- 



HYGIENE OF THE SKIN 139 

quently but not at the same time, may prove helpful. 
The hair of school children occasionally becomes 
infested with vermin. Under such circumstances 
kerosene should be rubbed into the hair immediately. 
It is a good practice for each child to arrange to have 
his hair examined frequently by an older member of 
the family. If vermin are present in the hair of other 
children, the teacher should be informed. 

67. Care of the nails. The nails should be care- 
fully trimmed with scissors to prevent them from 
breaking. They should be neatly rounded and should 
not project a great deal beyond the end of the fingers. 
Boys will find an inexpensive " nail clip " a con- 
venient instrument. These cost from ten to twenty- 
five cents and can be bought in drug stores. The nails 
should not be cleaned with a knife blade as it roughens 
the under surface, permitting dirt to collect there 
more easily. Biting the nails is usually due to ner- 
vousness. More out of door exercise should be taken 
and, if the case is pronounced, a physician should be 
consulted. One who wishes to overcome the habit 
can get aid by smearing laundry soap, red pepper, 
wormwood, or bitter aloes over the tips of the fingers. 

68. Callouses, bunions, warts, etc. It is always 
best to consult a specialist in regard to these matters. 
The science of Chiropody has developed greatly during 
the past few years and much help may be obtained 
from it. Blisters on the feet or aching feet are some- 
times relieved by holding the feet under cold, running 
water at night. Frequently, however, the trouble 
is due to misshapen shoes or fallen arches of the foot. 



140 HEALTH AND EFFICIENCY 

Much of the inconvenience caused by corns, nails, etc. 
can be prevented if constant attention is paid to the 
feet. If they are subject to irritation they should be 
washed in warm water daily, although soap need not 
always be used. The nails should be trimmed at fre- 
quent intervals, each time cutting straight across and 
not snipping off the corners. Corns may be made less 
annoying if rubbed with fine sandpaper. One of the 
most common causes of foot trouble is that of wear- 
ing shoes too short for the foot. Such shoes bind the 
feet and act as a constant irritant to the skin. Per- 
sons with tender or sore feet will find it helpful to 
change the shoes frequently and not attempt to break 
in a new shoe at once. House slippers rest not only 
the feet but the whole body. 

69. The hygiene of the clothing. The hygienic 
value of clothing lies, first, in its power of conducting 
heat, and secondly, in the power of absorbing moisture. 
Wool (made from the hair of sheep), cotton and linen 
(made from the fibers of plants), together with silk 
(made from the cocoons spun by the silk worm cater- 
pillar), make up a large part of our clothing. Loosely 
woven material (woolen cloth) is a poor conductor of 
heat, because its meshes are filled with air, which does 
not conduct heat well. Tightly woven cloth (cotton) 
is a good conductor of heat. Clothing therefore does 
not make heat, but on the other hand it either permits 
the heat of the body to pass into the air and therefore 
has a cooling effect, or it prevents the passage of heat 
and thus keeps the body warm. Several layers of thin 



HYGIENE OF THE SKIN 141 

clothing are warmer than a single layer of thick cloth- 
ing, because the layers of air between the layers of 
cloth prevent the passage of heat from the body. It 
is for this reason that layers of newspapers are some- 
times put under the clothing. 

Woolen clothing takes up perspiration rapidly and 
does not leave the body damp and chilled as other cloth- 
ing does. 

Clothing should be adjusted to the occupation and 
to the season. A person doing much muscular work 
does not need as much clothing as one doing little. 
Again, one should dress differently in school from 
what he does on the way to school. In winter, over- 
coats should be w r orn to school but they should be re- 
moved on entering the building. The same is true of 
rubbers and overshoes ; these are a necessity in stormy 
weather, but they are a source of ill health when worn 
indoors. Even shoes should be subject to seasonal 
changes — low shoes for summer, but not for 
winter. 

The dye in stockings frequently poisons the feet 
through blisters. If blisters form they should be thor- 
oughly washed and dried and then covered with a thin 
film of vaseline and a clean, soft white cloth wrapped 
over the injured part to protect it from the dye. 

Rubber clothing, such as a mackintosh, does not al- 
low the heat of the body to pass off readily, conse- 
quently such a garment, as well as rubbers, rubber 
boots, and overshoes should be removed as soon as pos- 
sible. Mackintoshes and rain coats should be pro- 



142 



HEALTH AND EFFICIENCY 



vided with large pores in the arm pit to allow ventila- 
tion. 

Socks should be changed frequently, since they ab- 
sorb the perspiration of the feet. Some persons find 




Photograph by Underwood & Underwood 

Fig. 58. — Examining immigrants near Ellis Island, N. Y. 
Clothing often harbors vermin 

it necessary to change the socks daily. The odor of 
the body should be a clean, pleasant one, but this 
cannot be unless bathing is frequent, the clothing 
changed often, the teeth kept clean and entire, and 
the toilet habits are regular. 

Tight garments compress the tissues, especially the 
blood vessels, and therefore interfere with the normal 
functioning of the body. Tight garters interfere with 
the supply of blood to the leg, and tight corsets not 



HYGIENE OF THE SKIN 143 

only interfere with the blood supply to the organs of 
the chest and abdomen but compress and distort the 
intestines, stomach, and liver. 

It is, of course, a mistake to wear light clothing in 
winter and furs in summer. Dressing in this fashion 
lowers the vitality of the body and consequently the 
resistance to disease. 

Tight hats are frequently a source of headaches. A 
cap should rest lightly on the head but should not set 
down so far as to distort the ears. 

Woolen clothing is warmer than cotton clothing, 
and is better adapted for winter wear. Woolen bath- 
ing suits are to be preferred to cotton. There is 
danger of dressing too warmly, as there is of dressing 
too coolly. If too much bed clothing is used, sleep 
will be interfered with, and too much clothing during 
the day may interfere with perspiration. On a cold 
night two thin bed covers are warmer than one thick 
one. Why? Dressing too warmly in the house dur- 
ing the winter time may lead to chills when one goes 
out of doors. Wet clothing is a source of danger as 
it may lead to colds, rheumatism, or pneumonia. Un- 
derwear should be changed frequently as it is con- 
stantly absorbing perspiration. It is well to hang up 
the undergarments at night so that they will be well 
aired. Of course, undergarments are intended for 
day wear and a different set of clothing should be 
worn at night. Xight clothes should be adapted to 
the season, should be washed frequently, and should be 
aired thoroughly during the day. 



144 HEALTH AND EFFICIENCY 

As soon as one rises in the morning the bed covers 
should be pulled down over the foot of the bed and the 
pillows put on chairs. If sunlight does not strike the 
bed, the bed clothing should be put near open windows. 



CHAPTER IX 
THE ORGANS OF SENSE 

70. The five senses. Bunyan has described the human 
head as the City of Man's Soul and has spoken of 
Satan attacking through the four gates of the city — 
Eargate, Eyegate, Nosegate, and Mouthgate. Bunyan 
of course meant by this that evil knowledge comes to 
our minds through these channels. It is equally true, 
however, that wisdom comes to us by the same paths. 
Through the eye comes the wisdom of the ages, pre- 
served in manuscript and print ; through the ear music 
and the solace of other voices; through the mouth and 
nose food and air, to sustain the mind in all its mani- 
festations. To the senses mentioned by Bunyan, feel- 
ing is commonly added, making five in all. As a mat- 
ter of fact, there are other senses which put us in touch 
with our environment, but the five mentioned are the 
ones commonly given. 

71. Structure of the human eye. The human eye is 
a very delicate and complicated organ which frequently 
becomes defective. Among high school pupils, as 
many as twenty per cent, have been found to have de- 
fective vision. Since the condition of the eye depends 
a great deal upon its care, and since that in turn de- 
pends a great deal on a knowledge of its structure and 
function, every student should be familiar with the 

i45 



146 



HEALTH AND EFFICIENCY 




59. — A man pointing awls has his eyes 
protected by a glass plate in the hood 



fully 



general structure of the eye. If you will examine the 
eye of another person, you notice that it is spherical 
in shape and has a black circular area in front. This 



THE ORGANS OF SENSE 



147 




Fig. 60. — A man chipping iron castings is exposed to eye 

injury 

small black area is surrounded by a colored area 
(brown, grey, blue, etc.), and this, in turn, by a white 
area. The black central area is the pupil, the sur- 



148 



HEALTH AND EFFICIENCY 



rounding, colored area is the iris, and the white area 
is a stout cloak which covers the rest of the eye. If 
you ask the person to shut his eyes for a minute and 
then to open them, you notice changes in the size of the 
pupil, especially if he looks first at objects near at hand 
and then at objects at a distance. You will also see 
that this change in the size of the pupil is due to the 
iris, which seems at times to pucker, making the pupil 




Fig. 61. — Shows spectacles worn by an employee in a 
steel foundry. A chip of steel from a casting 
destroyed one lense, as shown above, without injur- 
ing the eye of the wearer. 

smaller. The pupil is the window of the eye and the 
iris the curtain. If the iris is drawn back, much light 
goes into the eye, where it spreads out on the dark in- 
terior surface. It is this dark background that makes 
the pupil look black. The dark background, or retina, 
corresponds to the plate of a camera, and the rays of 
light falling on it leave an impression. As each im- 
pression is made on the retina, the eye nerve leading 
from the eye to the brain is stimulated and we see. 



THE ORGANS OF SENSE 149 

72. The care of the eye. The eye is easily irritated 
and quickly fatigued. It is, morover, subject to bac- 
terial infections. Because of this, care should be taken 
in the use of towels. Bacteria which have produced 
a disease in the eyes of one person are often trans- 
mitted to the eyes of another person through towels. 
Since we frequently rub our eyes during the day, it is 
necessary to keep the hands clean. The author knows 
of the case of a high school girl who lost the sight of 
one eye because of a disease transmitted from a sub- 
way strap to her hand and thence to the eye. The 
hands should always be washed before eating and 
should be washed frequently if one has come in con- 
tact with door knobs, car straps, etc., in public places. 
Soap is one of the best antiseptics known and should be 
used liberally. For general toilet purposes, castile 
soap is the best. If a foreign body, like a piece of dirt, 
gets into the eye, the eye should not be rubbed. The 
first thing to do is to take hold of the eye lashes of the 
upper lid and to pull the lid down and out. This will 
cause tears to run over the eyeball and over the inner 
surface of the upper lid. Frequently in this way, a 
foreign body can be washed ofif. Blowing the nose 
at the same time may accelerate the tear current. 

It is not advisable, under ordinary circumstances, to 
use any " wash " on the eye. Tears are Nature's eye 
wash, being composed of salt and water, and having a 
tonic action on the eye. If the eye is inflamed or if 
a mucilaginous substance accumulates at the edge of 
the lids, warm water, to which boric acid has been 
added, will reinforce the action of the tears. If the 



150 HEALTH AND EFFICIENCY 

condition is not corrected by this treatment, a physi- 
cian should be consulted. There are some persons 
who make a practice of washing out the eyes with 
water, thinking that the eyes need to be washed. This 
is ordinarily not true, as the tear glands are constantly 
secreting a wash which cleans the eye as much as 
is necessary. 

The work of the eye is interfered with by reading 
while one is lying down, or in a moving vehicle, or 
through a veil, or in a dim or flickering light. A per- 
son should not face the light while reading, but the 
light should come from behind and preferably over 
the left shoulder. The book should be held in such a 
way that it receives the most favorable degree of light. 
The proper reading distance is fourteen inches for or- 
dinary type and school chairs and desks should be ad- 
justed accordingly. Motion pictures are a strain to 
the eye and if watched more than occasionally not 
only fatigue the eye but produce headaches and nausea. 

73. Artificial light. When one has a choice of arti- 
ficial light, it is well to use some discrimination. The 
naked gas flame and the candle flame are so uneven 
that they flicker and. throw fine shadows across the 
page, easily fatiguing the eye. A gas flame of any 
kind is objectionable because of the gas which escapes 
and because of the poisonous products formed during 
burning. Some plants are so sensitive to these poisons 
that they die in a few hours if left in a room where 
gas is burning. For a student's lamp, the acetylene 
kind does very well. If an electric light is used, care 
should be taken that it is not too bright and that it 



THE ORGANS OF SENSE 



151 













209 


B C 


E T P R - 


F Z B D E 


OFLCTG - 


AEORPTDZ « 


UPRTVZBDFH ■ • 


YVCEZLNP to 



Fig. 62. 
Snelling Chart 



152 HEALTH AND EFFICIENCY 

does not shine directly into the eyes. All light should 
come from above, preferably from the left, and should 
be of sufficient intensity to enable one to read com- 
fortably. It is a good plan to close the eyes for a few 
minutes each day, in order to rest them. 

74. Defects of vision. Headaches, sick stomach, 
aching eyes, blurred vision, a scowling forehead, and 
squinting eyes are frequently symptoms of defective 
eye sight. The lens in the front of the eye should be 
able to adjust itself to near and far objects. When it 
is not able to do so, objects appear blurred. Again, 
if the front of the eyeball is not perfectly round, ob- 
jects appear blurred and a person is said to have " as- 
tigmatism. " The vision can be easily examined by 
means of the Snelling Chart, a reduced copy of which 
is shown on page 151. In a comfortably lighted room, 
one should be able to read line 30 of the full sized chart 
from the left to right and from the right to left, at a 
distance of thirty feet ; line 20, at a distance of twenty 
feet; and line 15, at a distance of fifteen feet. If one 
is unable to do this, it would be well to consult a spe- 
cialist on the eye. 

75. The structure and care of the ear. What we 
usually speak of as the ear is only the outer ear, which 
exists for the purpose of catching sounds. Leading in- 
ward from this is a canal, which has a thin sheet of 
membrane, called the drum, stretched across it at its 
inner end. Connected with the drum at its inner sur- 
face are some delicate bones to which the sound vibra- 
tions are transmitted. The waves are finally carried 
to a sensitive chamber, called the inner ear, whence 
impulses are sent, through the ear nerves, to the brain. 



THE ORGANS OF SENSE 153 

A thick, brownish substance, called wax, is normally 
present in the canal and rolls out onto a handkerchief 
or towel when the external ear is agitated. Sometimes 
people try to remove the wax from the ear by using a 
hairpin, match, or corner of a towel. There is much 
danger in doing this, as it is easy to rupture the ear 
drum. An old rule says that nothing smaller than the 
elbow should be put in the ear. If the wax does not 
roll out of the ear, but collects in a ball, it interferes 
with the hearing and produces a throbbing or ring- 
ing. Many persons who think that they are deaf, 
might have their hearing restored by the removal of 
the wax. This, however, should be done by a physi- 
cian. It is a very simple procedure and involves no 
pain. 

Pain in the ear, or a liquid discharge, usually means 
trouble. A physician should be consulted if there is 
a discharge or if the pain persists. Sometimes a sim- 
ple case of ear ache can be relieved by a few drops of 
warm olive oil, dropped into the ear while one lies on 
his side. In doing this, it is best to pull the external 
ear upward and outward so as to make the canal 
straight. After the oil has been dropped in, it is well 
to fill a small bottle with hot water and apply it to the 
ear. If the bottle is too hot at first, a towel can be 
wrapped about it. 

If an insect gets into the ear, one should not get ex- 
cited, for a little warm water put in the ear will cause 
the creature to float out. If children put beans or 
buttons in the ear, it is always best to have a physician 
remove them. 



154 HEALTH AND EFFICIENCY 

Pulling children by the ears, or boxing the ears, is 
a very dangerous practice, as it may result in tearing 
the ear drums. Diving is also attended with consider- 
able danger, as the sudden change of pressure may 
rupture the drum. 

While deafness may be caused by wax or foreign 
bodies in the canal and by rupturing the drum, tempo- 
rary deafness is frequently associated with colds. The 
reason for this is that the tubes leading from the 
middle ear to the throat may become clogged with 
mucous. The condition usually disappears when the 
cold gets better. 



CHAPTER X 

MENTAL HYGIENE 

76. The human brain is located in the head and is 
almost completely enclosed by the bones of the skull. 
Running to it from the eyes, nose, and ears are nerves 
which tell us what is around us, and running from it 
are nerves which control the heart, lungs, and certain 
muscles of the throat, jaws, and tongue. The sub- 
stance of the brain continues down through the verte- 
bral column as the spinal cord, which has branches 
running to the abdomen and appendages. 

The brain varies in shape and size. Attempts have 
been made to show that intelligence depends upon the 
size or shape or chemical composition of the brain. 
All such attempts have failed. The average Anglo 
Saxon brain weights about three pounds. Men of un- 
usual intelligence have had brains which have weighed 
both more and less than this. Thus the brain of 
Cuvier, the great scientist, weighed about four pounds, 
while that of Gambetta, the French statesman, weigh- 
ed only two and a half pounds. Occasionally one 
reads that intelligence is dependent upon the amount of 
phosphorus present in the brain, but there are at 
least two animals whose brains contain more phosphor- 
us than the human brain — the sheep and the goose. 
No attention need be paid therefore to the arguments 

i55 



156 



HEALTH AND EFFICIENCY 



of phrenologists, who say that they are able to describe 
one's abilities after an examination of the skull, or to 
patent medicine fakers, who claim to have discovered 
a medicine containing elements which will produce new 
brain tissue. Certain medicinal remedies, to be sure, 




Photograph from Western Newspaper Union 

Fig. 63. — Leon Gambetta — a distinguished French 
statesman 

stimulate the brain but they supply no new tissue and 
should be used only under a physician's direction. If 
brain tissue is needed, the body can build it if supplied 
with such foods as vegetables, milk, eggs, and cereals, 



MENTAL HYGIENE 157 

and the mind, in turn, can be trained by an application 
of the "will power. 

77. Why we should study mental hygiene. Ner- 
vous breakdowns, paralytic strokes, insanity, and ner- 
vousness in general are increasing at an alarming rate. 
Nerve racking travel, hurried meals, the din produced 
by whistles, bells, wagons, cars, and trains, the high 
pitched quest for money, the anxiety incident to keep- 
ing a certain social standard, the tremendous responsi- 
bilities assumed by business men and women, together 
with an atmosphere of fault finding, are slowly but 
surely undermining our nervous fiber. The death 
rate for middle aged people is much higher in America 
than in Europe, and insanity is much more common 
in the city than in the country. It is probably true 
that many chronic diseases such as indigestion, dia- 
betes, ulcers of the stomach, etc., are fundamentally 
due to a weakened nervous system. So alarming has 
the condition become that thousands of city people 
are looking forward to the time when they will be able 
to return to the soil from which their parents came. 

78. Headache. It w r as pointed out in a previous 
chapter that headache may be a symptom of over 
twenty different ailments. Headache is, therefore, a 
warning that something is wrong with the machinery 
of the body and serves the same purpose as a red light 
on a railroad track. So does all pain. To suppress 
a headache with aspirin or a headache powder, is to 
destroy Nature's warnings. It is as rash as would 
be the engineer who would destroy a red lantern ahead 



158 HEALTH AND EFFICIENCY 

of his train. If you suffer from headaches, find out 
whether you need glasses or whether a cathartic is 
needed or just what is the cause. This can best be 
done by consulting a physician. If it does not seem 
advisable to do this, consult your Hygiene teacher or 
the School Nurse. Remember that you can be of in- 
dispensable assistance to the physician by taking a great 
deal of exercise in the open air, by frequent baths 
(cold baths have a stimulating action, while hot ones 
have a soothing effect), by sleeping nine hours at night, 
by a well selected diet, by avoiding eye strain, and by 
having needed dental work done. 

79. Nervousness. This condition may be indi- 
cated by restlessness, lack of will power, twitching, ten- 
dency to worry or to be easily startled, biting finger- 
nails, etc., or there may be a decided lack of energy 
and a general indifference. Nervousness is said to be 
much more common among clerks, students, and teach- 
ers than among farmers, laborers, and fishermen. This 
gives us a suggestion as to its treatment. It responds 
readily to exercise out of doors, to a well regulated 
diet, containing plenty of fresh vegetables, dark bread, 
milk, and eggs. 

80. Epilepsy. This trouble is characterized by con- 
vulsions or fits, and should be treated by a physician. 
Not all convulsions are caused by epilepsy, however, as 
they are not infrequently due to auto intoxication, eye 
strain, decayed teeth, intestinal parasites, and nasal 
growths. It is always advisable to consult a physician 
whenever this symptom occurs. 

81. Fears and suppressed emotions. Fears may 



MENTAL HYGIENE 159 

be reasonable or unreasonable; examples of unreason- 
able fears are fear of the dark, fear of a catastrophe, 
fear of being unable to sleep, etc. The best way to 
conquer a fear of this sort is by a close study of the 
facts involved — do they warrant such a fear ; and by 
attempting to get accustomed to the feared situation. 
If the fear persists in spite of all that you can do, con- 
sult a person who you think will understand your 
case. 

82. Friends of our nerves. Boys and girls who 
are lacking in energy, or who are pale, or fretty, or 
" fidgety," who bite their fingernails, or sleep poorly, or 
lack the ability to apply themselves, can receive help 
from Nature. Do not use patent medicines. You 
may not know what is in them but even if you do the 
medicine may do you more harm than good. Follow 
the general rules of Hygiene and if more is needed 
consult a physician. 

Get nine hours of sleep or rest. It is a good plan 
to retire not later than ten o'clock and to arise by 
seven. Sleep with the windows open, out of doors if 
possible, and use just as little bed clothing as is nec- 
essary. On arising, perform the exercises outlined in 
Chapter III. These may be followed by a neutral 
bath (water neither hot nor cold). Before eating 
breakfast drink a glass of water. Eat your meals 
slowly and eat freely of whole wheat and bran bread, 
cereals like oatmeal and cornmeal, beef and mutton 
soups and stews, as well as fruits and vegetables that 
you like and can afford. Chew the food thoroughly; 
remember that the wastes of the body will produce 



160 HEALTH AND EFFICIENCY 

poisoning, if not excreted regularly.. Keep in the cool, 
open air as much as possible, doing what you most 
enjoy — ■ walking, fishing, playing ball, etc. Nature 
study is a better remedy for tired nerves than motion 
pictures. Get interested in something — a story, or 
stamps, a game, a vocation, or w r ork, such as that of 
the Big Brothers, Big Sisters, or Scouts. Be very 
careful of your habits ! Avoid tea, coffee, and to- 
bacco. Avoid morbid and distressing stories. Mold 
your habits and character so that some other person 
will have faith in you and develop to the utmost your 
reliance on God. 

83. Reflex actions. When a particle of dust gets 
into the eye, the lids of the eyes immediately close and 
tears flow over the eyeball ; when the hand touches a 
hot object, the muscles of the arm and hand contract 
and the hand is quickly withdrawn ; and again when a 
fishbone gets in the throat, the muscles of the thorax 
contract and coughing is produced in an effort to ex- 
pell the object. All of these incidents are examples of 
reflex actions. They happen in the twinkle of an eye. 
They take place so quickly that we are not immediately 
conscious of them. Yet notice the purpose that they 
serve. In the first instance, the closure of the eye 
prevents more dust gaining entrance and the flow of 
tears aids the eye in removing the particle already 
there; in the second instance, the contraction of the 
arm muscles draws the hand away from the hot object ; 
in the third instance, the coughing is the body's effort 
to expel the fishbone. Reflex actions are character- 
ized, therefore, (1) by the rapidity with which they 



MENTAL HYGIENE 



161 



take place, (2) by the absence of volition, and (3) by 
the fact that they aid in protecting the body. What 
are the events of a reflex act? These can be best 
studied in the reflex produced by a hot object, since 
the action is familiar and involves only parts well 
known. The first event in this reflex was the feeling 



^-Skin 




Spinal cord 




Sweat gland 



Sensory nerve affected 
by warmth 

Motor (secretory; nerve to 

Motor nerve cells 
Intermediate nerve cells 
Motor (vasodilator) nerves to blood vessels of skin 



Fig. 64. — Diagram showing a part of the reflex mechan- 
ism of the blood-vessels in the skin and in the 
secretion of perspiration. (From Fitz.) 

of heat by the sensitive parts of the skin. Moreover, 
the heat was so intense that it produced an impulse 
passing along the nerves leading from the burned area 
of the skin, to the spinal cord. From the cord, an im- 
pulse was sent outward along nerves supplying the 
muscles which bend the arm. The impulse, on reach- 
ing the terminations of the nerves in the arm, caused 



162 HEALTH AND EFFICIENCY 

the muscle to contract and the arm to be drawn away 
from the heat. The reflex act involved, therefore, ( i ) 
the surface receiving the stimulation (the skin) ; (2) 
a nerve along which an impulse passed to the central 
nervous system; (3) the spinal cord (a part of the 
central nervous system) ; (4) a nerve along which an 
impulse passed from the cord to the (5) muscle. Any 
reflex act is said, therefore, to involve: 

(1) Receptor; 

(2) Afferent nerve; 

(3) Central nervous system; 

(4) Efferent nerve; 

(5) Effector. 

The nerve impulse which produces the reflex act 
passes from one part of the nervous system to another 
by way of nerve cells or neurons. These are very ir- 
regular, branched cells, with long, thin processes — one 
of these being longer than the others and being called 
an axon. Nerves are bundles of axons belonging to 
cells of the central nervous system. Although one 
nerve cell is probably not actually continuous with 
other nerve cells, yet the end of one is placed very 
close to the beginning of another. There are, however, 
gaps between the neurons which have to be passed over 
by the nerve impulse. It is here that fatigue takes 
place and it is probably on these parts that such drugs 
as caffeine and chloroform act. 

84. Habits. Such reflex actions as we have just 
discussed do not have to be learned — they are inborn 
in the individual. A baby draws his hand away from 



MENTAL HYGIENE 163 

the hot stove and attempts to expel an irritating ob- 
ject in his throat almost as quickly as an adult. How- 
ever, some reflex actions are learned — writing, walk- 
ing, dressing, etc. Each of these actions was 
performed in the beginning only with considerable 
labor, and close attention. As the action was per- 
formed over and over again, it not only became easier 
and required less attention but it was done better and 
at a great saving to the nervous system, sparing the 
higher centers (cerebrum) for other thought processes, 
and delegating to the lower centers (spinal cord and 
medulla) the task of carrying out a multitude of simple 
reflexes. How tired your mind would be at the end 
of a day if you had to think out each motion in dress- 
ing, washing, brushing the hair, eating, preparing for 
school, choosing the route, carrying books, etc., etc. 
You would have little mental energy left for your 
studies. For these reasons Professor William James 
says that the " practical effects of a habit are 

(i) Habit simplifies our movements, makes them 

accurate, and diminishes fatigue. 
(2) Habit diminishes the conscious attention with 

which our acts are performed. " 

If the acquisition of habits has such a great value to 
the individual, conserving his nervous energy and giv- 
ing an opportunity to take up additional educational 
tasks, it is of the greatest importance to have a few 
rules in mind to serve as a guide in the acquisition of 
good habits and in the breaking of bad ones. Pro- 
fessor James gives these as follows : 



164 HEALTH AND EFFICIENCY 

(i) In the acquisition of a new habit, or the leaving 
off of an old one, we must take care to launch 
ourselves with as strong and decided an in- 
itiative as possible. 
To take for instance the case of a man who is 
constantly late to work or the pupil con- 
stantly late to school, the application of this 
rule would involve such acts as buying an 
alarm clock, announcing to friends the new 
resolve and the making of appointments 
which necessitate one's presence in office or 
school before the opening hour. 

(2) Never suffer an exception to occur till the new 

habit is securely rooted in your life. Pro- 
fessor James says that one lapse is like the 
letting fall of a ball of string which one is 
carefully winding up ; a single slip undoes 
more than a great many turns will wind again. 

(3) Seize the very first possible opportunity to act 

on every resolution you make, and on every 
emotional prompting you may experience in 
the direction of the habits you aspire to gain. 
In this connection Professor James says : " No 
matter how full a reservoir of maxims one 
may possess, and no matter how good one's 
sentiments may be, if one has not taken ad- 
vantage of every concrete opportunity to act, 
one's character may remain entirely unaf- 
fected for the better." 

Before you leave this subject think of one bad habit 
which you would like to be rid of, and of an opposite 



MENTAL HYGIENE 165 

virtue which you know that you should cultivate. 
Begin now, strike while the iron is hot, and keep per- 
sistently at it each day until you have conquered. 

85. The power of concentration. It is said that 
Charles Darwin, the great English scientist, was per- 
mitted by his physician to work, during the latter part 
of his life, only four hours a day. Yet so great was 
his ability to concentrate on the work at hand that he 
was able to accomplish several investigations, any one 
of which would have been considered a life work by 
most men. The ability to keep the mind to the im- 
mediate task is one of the most fruitful of mental 
accomplishments. It enables one to do more work of 
a better quality than would otherwise be the case. 
Most pupils fritter away their time. They think that 
they study, whereas from one-half to two-thirds of the 
time is spent in day dreaming. 

As an experimental study of your powers of concen- 
tration note the time when you begin the study of one 
of your lessons and make a check on a slip of paper 
every time you find your mind is not on the w T ork. 
Note the time necessary to accomplish this lesson. 
Keep a record of these figures and note how much your 
ability to apply yourself increases. 

If you find it particularly difficult to concentrate, ask 
yourself what the possible causes may be. Do you 
take plenty of exercise? You should be out of doors 
as much as possible. Does your diet include the foods 
indicated as essential in Chapter V? Do you get nine 
hours of sleep each night? Do you drink tea or cof- 
fee or use other drugs — if so, stop it. Do you have 



166 HEALTH AND EFFICIENCY 

a quiet room for study? If not, can't you arrange 
to use a public library or another suitable place ? Are 
you interested in your studies? If not, talk over the 
difficulties with the teacher or principal. Finally, have 
you selected the right companions — those of your 
own age and those who are seriously interested in 
school work? 

86. Steps to success. Just as some of the deepest 
sinners have become some of the greatest saints, so 
also have boys and girls, who at first showed little 
talent or promise of success, become leading thinkers 
and workers. In some cases, this can be explained by 
a lack of appreciation or sympathy on the part of par- 
ents or teachers. In other cases, however, it has been 
due to self discipline — the individual recognizing his 
shortcomings and striving to correct his weakness. It 
is well for a pupil to form a close friendship with 
a teacher and to invite the latter to point out his 
weak points. Study the biography, or better the auto- 
biography, of someone you greatly admire, to find out 
what some great man or woman has done to achieve 
success. Strengthen your memory and your powers 
of discrimination by keeping a diary and by taking 
notes on lectures and speeches. Keep a small note 
book where you can enter the names of books or maga- 
zine articles that have proved of value to you. It is 
usually too much of a task to carry these things in the 
mind but if they are carefully entered in a note book 
they will serve as pegs upon which to hang other facts. 
If a certain opinion regarding the cause of a period of 
rainy weather is current in your neighborhood, inves- 



MENTAL HYGIENE 167 

tigate it to see if the facts support the theory. Many 
persons believe that flies develop out of rotten fish. 
Is it true? Others believe that a horse hair kept in 
water for nine days will develop into an eel. Will it? 
Before you express an opinion run over in your mind 
the facts bearing on the case. A person of sound 
judgment is one of the most valuable members of a 
community. If you are interested in insects or flow- 
ers or machinery or houses, learn to make simple, ac- 
curate, labeled drawings of the objects. In the midst 
of confusion, keep your wits. 

87. The discipline of studies. Contact with Nature 
is the best school for training the senses. The fine 
lines, delicate coloring, the estimation of distances train 
the eye, while the perception of slight sounds, such as 
those made by the movements of small animals or the 
interpretation of bird and insect notes, train the ear. 
Books and contact with other minds discipline and en- 
rich the mind. The educated American who is unfa- 
miliar with the history of democratic movements is as 
lame as the cripple who hobbles down the street with 
the aid of a cane, and the man who lacks confidence in 
his ability to " tackle " a problem or the man who con- 
tinually makes snap judgments is as much handicapped 
in a struggle to get somewhere as he would be if his 
legs were tied together. 



CHAPTER XI 
FIRST AID 

88. Fires and panics. Young men and women can 
be of very great service in time of panics if they keep 
their wits and station themselves at favorable places to 
direct and calm others. In case of accidents, try to be 
of service instead of standing by and idly looking en. 
In cases of fire, find the nearest alarm and, following 
directions carefully, put in a call for help. Do you 
know the location of the Fire Alarm Boxes nearest 
to your home and to the school? Do you know pre- 
cisely how to ring in an alarm? If you do not, get 
the information before you go home to-night. 

If you are in a burning building, remember that 
the air within six inches of the floor is free from smoke. 
If it is necessary to carry an insensible person from 
a smoke filled room, tie his hands together with a 
handkerchief and put them over your head, and you 
can crawl along the floor, dragging the person with 
you. 

If your clothing should catch fire, roll over on the 
floor to smother the flames. If a mat or heavy blanket 
is at hand, roll up in that as tightly as you can. If the 
clothes of another person catch fire, roll him up :n a 
coat, mat, or blanket. 

89. Burns and scalds. The painfulness of a burn 

168 



FIRST AID 



169 



or scald can be relieved by applying a paste made by 
adding a little water to soda, flour, cornstarch, or by 
gently rubbing on a little vaseline, cream, or oil. Prob- 
ably the handiest and simplest application is soap. It 
can be softened a little by putting it in hot water. Do 
not try to remove clothing that sticks to a burn. Such 
a burn is serious and needs the attention of a phy- 
sician. 




Photograph from Underwood & Underwood 

Fig. 65. — Los Angeles firemen learning how to rescue 
those overcome by smoke 

90. Ice rescue and drowning. If it becomes neces- 
sary for you to attempt the rescue of a person who has 
broken through the ice, you should first tie a rope 
around your body and have the other end tied or held 
on shore. To approach the person, lie on your stom- 
ach and push ahead of you a pole or board or ladder, 
until the person can reach it. If you break through 



170 HEALTH AND EFFICIENCY 

the ice, and rescuers are near, support yourself on the 
edge of the ice until help arrives. 

In case of apparent drowning, lay the person on his 
stomach, face a little to one side, so as to allow the 
water to run out of his lungs. Then getting astride 
the person press the hands into the region of the 
short ribs to force water out of the lungs. Relax the 
pressure now to draw air into the lungs. Repeat this 
process at intervals of four seconds. It may be neces- 
sary to keep it up for an hour or two before signs of 
life appear. 

91. Fractures. In case a leg is broken, make the in- 
jured person as comfortable as possible, supporting 
the leg so that it will lie flat. If it becomes necessary 
to move the person and a stretcher is not available, 
perhaps a door can be unhinged and used as a stretcher. 
If the skin has been broken and antiseptics are avail- 
able, wash the wound gently and then cover it with a 
piece of clean cloth. In order to prevent movement 
of the limb, a board, running from the sole of the 
foot to the arm pit, should be bound to the leg and to 
the body. A short splint on the inside of the leg, cov- 
ering the fracture, will help to further hold the leg in 
position until a physician can be obtained. In general 
a patient with a broken bone should be made as com- 
fortable as possible until medical aid can be obtained. 
Great care should be taken, in the case of fractured 
arms or legs, not to bend the part, as the bones will 
be displaced and the skin may be ruptured, which may 
produce an infection. 

92. Bruises, sprains, and dislocation. If a joint 



FIRST AID 171 

of the arm or leg is sprained, put that part in an el- 
evated position and wrap cloths wrung out in hot or 
cold water around it. The joint must be given perfect 
rest and the cloths should be kept tight about the limb 
and changed frequently. A bruise should be painted 
with iodine or washed with some other antiseptic and 
then bathed in hot or cold w T ater. Do not try to get a 
dislocated joint back in place. Cover the joint with 
hot or cold applications and take the person to a doctor. 

93. Slight wounds (pin pricks, cuts, or tears). 
Suck some of the blood from the wound and then wash 
it with iodine. 

94. Wounds with severe bleeding. Bleeding from 
a cut artery is more dangerous than bleeding from a 
cut vein, as the blood is coming direct from the heart. 
If the artery is cut, the blood is bright red in color and 
spurts out of the wound. In such a case, tie a tourni- 
quet around the limb, between the wound and heart. 
The tourniquet can be made by tying a handkerchief 
loosely but making the knot tight, and then slipping a 
stick under the handkerchief and twisting it so that the 
handkerchief binds the limb tightly. If the wound is 
not in a limb, press the finger into the flesh between 
the wound and heart, to see if you can feel the pul- 
sating artery. When you do, press a small block of 
wood or a stone on this point, so as to prevent further 
bleeding. If a vein has been cut, a pad or cloth fixed 
firmly on the wound will usually prevent further bleed- 
ing. If a vein in the neck is cut, blood is lost so 
rapidly that the person is in danger of immediate 
death and the finger should be applied immediately. 



172 



HEALTH AND EFFICIENCY 



Tourniquets should not be left on longer than half an 
hour. 

95. Fainting. If the face is pale, lay the patient on 
his back in a horizontal position. If the face is red, 
raise the head on a pillow or coat. Loosen the cloth- 
ing about the neck and chest. Put a cloth wrung out 
in cold water over the forehead and sprinkle cold water 




Fig. 66. — A fresh air class 

on the face. Rub the limbs toward the body. Do not 
allow the patient to get up until he has fully recovered. 

96. Frostbite. Rub the frozen part gently and 
gradually with snow or cold water until the flesh be- 
comes warm and begins to sting or burn. The patient 
should endeavor to exercise the part when this occurs. 

97. Poisoning. First send for a physician at once, 
then do as follows: If a poisonous substance has been 
taken, prompt effort should be made to produce vomit- 



FIRST AID 173 

ing. The first thing to do is to give a cup or bowl of 
lukewarm water to which salt or mustard may be 
added. This will hasten vomiting but it is well to put 
the finger back in the throat as soon as the liquid has 
been taken. Repeat the dose several times, using large 
quantities of water. If a strong acid has been taken, 
baking powder, plaster from the walls, or soap should 
be added to the water. If an alkali has been taken, 
dilute vinegar or lemon juice should be used. If the 
tissues have been badly irritated, olive oil or milk to 
which a beaten egg has been added, should be given. 

98. Ivy Poisoning. Poison ivy grows as a trailing 
vine or as a shrub and can usually be recognized by its 
clusters of three leaves. The leaves are long and nar- 
row, dark green above and lighter below. It is com- 
monly found along stone walls, fences, rocks, or twisted 
around the trunks of trees. The juice of the leaves, 
roots, flowers, and green fruit causes an irritation of 
the skin which is not fatal but very annoying. Poison- 
ing may be caused by contact with the plant or by 
handling clothing or utensils which have been in contact 
with it. It is possible that its pollen, which is carried 
long distances by the winds, is capable of causing the 
poisoning. 

Some persons are more resistant to the disease than 
others, but it is not probable that any are entirely im- 
mune. The parts of the body most frequently attacked 
are the hands, face, and forearms. Burning and itch- 
ing are the first symptoms of the trouble, followed by 
inflammation of the skin and a fine rash. There is a 
strong desire to scratch which gives but slight relief 



174 HEALTH AND EFFICIENCY 

and often tends to aggravate the irritation and is 
liable to spread the poison to other parts of the body. 

If one is known to have been in contact with the 
plant, prompt and thorough washing with soap and hot 
water will almost surely prevent the irritation. The 
washing must be very thorough and may be followed 
by washing with lime water, alcohol, or household am- 
monia, diluted with an equal amount of water. If 
these remedies do not prove successful it is best to con- 
sult a competent physician. 

99. Nosebleed. Loosen the collar. Do not blow 
the nose. Apply a piece of ice or a handkerchief 
wrung out in cold water to the back of the neck. A 
wad of paper inserted between the upper lip and gum 
will help. If bleeding continues, plug the nostrils with 
cotton and consult a physician. 

100. Convulsions (fits). Convulsions are often a 
symptom of a disease called epilepsy, in which the per- 
son gnashes the teeth, froths at the mouth, and then 
falls unconscious. No attempt should be made to pre- 
vent the movements, but the patient should be placed on 
the ground or floor and protected from harm as gently 
as possibly. If there is danger of biting the tongue, it 
is well to insert a piece of wood or a wad of paper 
between the teeth and then hold it in place. No effort 
should be made to rouse the person but he should be al- 
lowed to sleep until he awakens naturally. 

10 1. Sunstroke. By this is meant a sudden attack 
of illness from over exposure to heat. 

If the body is very warm the treatment consists in 
reducing the temperature of the body as rapidly as 



FIRST AID 175 

possible by bathing with cold water and by the appli- 
cation of ice. 

If the body feels cool, the treatment consists in rub- 
bing the surface of the body and the extremities, and 
the application of hot water bottles to the feet. The 
body should be covered with blankets, and kept warm. 
If the head becomes hot, apply cold water to it. 



PART II 
SCHOOL AND HOME HYGIENE 



CHAPTER XII 
SCHOOL HYGIENE 

102. Introduction. The school is your home for at 
least six hours a day and you should do all that you 
can to make it a healthy and beautiful place to live in. 
If the building is new and well constructed, preserve 
it for others. Wipe your feet on mats when you enter; 
refrain from throwing papers or waste on the floors 
— ■ use the waste basket ; don't leave fingermarks on 
the walls ; don't mark up desks and walls ; don't pol- 
lute the air by sneezing or spitting; pick up papers 
from the floor ; and finally, keep your desk so clean that 
you will be proud of it. Present a tidy appearance 
yourself. Use soap and water on your hands and face 
before coming to school ; have your hair neatly brushed, 
and your finger nails cleaned. If the building is not 
what you would like it to be, show the city fathers 
that you appreciate even what has been given to you 
and then present to them a dignified, well thought out 
appeal for improvements. The pupils of the Julia 
Richman High School of New York were housed in 
five buildings, one of which was built in 1847. The 
rooms in this building were poorly ventilated and 
classes were separated from one another only by cur- 
tains. The working conditions were almost unbear- 
able. The pupils took an inventory of their school 

179 



180 



HEALTH AND EFFICIENCY 



home, drew up a brief, and presented an argument to 
the school and municipal authorities for a new build- 
ing. Their efforts were rewarded by the allotment of 
$325,000 for the purchase of a new site upon which a 
new building will be erected to house the entire school. 
103. A study in school hygiene. Put a numbered 
label on each of ten test tubes containing sterile agar. 
Do not open No. 1 ; leave No. 2 open for thirty min- 




Copyright by Underwood & Underwood 

Fig. 67. — Small girls make good housekeepers later 

utes in the class room during a recitation period ; leave 
No. 3 open for thirty minutes in the hall or corridor, 
while classes are passing; put two or three drops of 
water from a school faucet or drinking fountain in No. 
4; put a few drops of thoroughly boiled w T ater in No. 
5 ; open No. 6 quickly and have a pupil who has just 
washed his hands touch the agar in two or three 



SCHOOL HYGIENE 



181 



places with his fingers ; have a pupil who has not 
washed his hands for two or three hours touch the agar 
in No. 7 ; open No. 8 in the room for five minutes 
and then leave it in the sunlight ; do the same with No. 
9 but put it in a dark place ; touch the feet of a fly to 
the agar in No. io. Keep the tubes at room temper- 
ature for a week. 

(a) Compare numbers I, 2, and 3. Which one has 




Fig. 68. — A school dental clinic 



the greatest number of bacteria or mold colonies? 
Which the least? Explain. 

(b) Why is it advisable to boil water if one is camp- 



ing? 



(c) Name a good antiseptic for the hands. 

(d) Why should a house be supplied with an abund- 
ance of sunlight? 

(e) Why are flies objectionable? 



182 



HEALTH AND EFFICIENCY 



104. Care of drinking fountains, cups, and toilets. 

Only a few years ago, it was a common practice for 
many persons in homes, schools, and shops to use the 
same drinking cups and towels. These have now been 
replaced in most cases by water fountains and indi- 
vidual paper towels, and they will be replaced in all 
cases if the public will agitate actively against them. 
Such common utensils are a source of very great dan- 
ger, because they frequently act as distributing agents 
for eye and skin diseases and certain internal diseases 




Fig. 69. — A school garden 

like typhoid. Pupils should note here, however, a pos- 
sible source of danger in drinking fountains. The jet 
of water should rise at least two inches above the top 
of the fountain so that it is not necessary for the lips 
of the drinker to come in contact with the fountain 
itself. If the lips do come in contact with the foun- 
tain, the latter may become a source of infection, as 
disease germs may be caught in the currents which re- 
volve about the mouth of the fountain. Each pupil 
should be a Hygiene Inspector and, if he sees another 



SCHOOL HYGIENE 183 

pupil misusing a fountain, should report the fact to the 
proper school authority. 

105. Lunch rooms. It is an act of self-protection 
for pupils to insist that food at the lunch counter be 
covered as much as circumstances will permit. Glass 
cases should be provided to prevent handling of food 
and also to keep dust from settling on it. Paper cups 
should be used tor drinking purpose^. Milk should be 
covered and school authorities should be provided with 
a lactometer to test the composition of the milk. The 
woodwork should be washed with soap and water and 
the floors cleaned frequently. Waiters at the counters 
should be required to wash their hands with soap and 
water before beginning work and to present a tidy ap- 
pearance. 

106. Inspection of janitorial service. Pupils can 
be of great service to their school if they will report to 
the principal, or to some one designated by him, in- 
stances where janitorial service is unsatisfactory. 
There may be cases w T here sweeping has not been done, 
or where rooms have not been heated or ventilated, or 
where dry cleaning has been resorted to. Except 
where expressly permitted, rooms should not be swept 
during school hours. Special cases may be allowed in 
the discretion of the principal. Halls should be 
cleaned by means of oiled brushes or by first sprinkling 
the floor with oiled sawdust and then sweeping it up. 
Toilets should be w r ell ventilated and kept in an effi- 
cient, sanitary condition. 

107. Hygiene and Sanitary Squads. Pupils who 
are particularly interested in the upkeep of the school 



184 HEALTH AND EFFICIENCY 

can be of service by organizing squads for the purpose 
of supervising the lunch room, the general sanitation 
of the building, or the personal hygiene of the pupils. 
Much good can be accomplished in this way as, both 
by suggestion and example, other pupils will come to 
understand that cleanliness comes next to godliness. 



CHAPTER XIII 
HYGIENE OF THE HOME 

1 08. Ideals in home building. Inasmuch as Amer- 
ica is relatively a thinly populated country, most per- 
sons have some freedom of choice in the selection of 
a home. There are great areas in the east, west, north, 
and south that would afford opportunities to many per- 
sons for earning a livelihood and for healthy living. 
Furthermore, adjoining the large cities, are the subur- 
ban districts, where each man may have his own land 
and home. Aside from the matter of convenience, ex- 
pense, etc., the sanitary aspects of home building, which 
may be called the ideals in home building, should al- 
ways be taken into consideration. These are : ( 1 ) the 
home should be built on high, dry land; (2) it should 
be well lighted but should have a few shade trees near ; 
(3) it should be provided with a sanitary water system 
— either well or reservoir; (4) it should be connected 
with a well conducted sewage system; (5) it should 
have a large, dry cellar; (6) it should be well sheltered 
from prevailing winter storms; (7) it should have an 
efficient heating and lighting system. 

109. Keeping a home clean. Benjamin Franklin 
urged cleanliness in all things — body cleanliness, clean- 
liness of clothing, and cleanliness of habitation. A lack 
of cleanliness means slovenly habits, both mental and 

185 



186 HEALTH AND EFFICIENCY 

physical. The successful business and professional 
men are those who keep their offices well ordered and 
who themselves present a tidy, neat appearance. Boys 
and girls should keep this in mind, as they will be 
judged largely by these points when they come in con- 
tact with teachers and employers. It is difficult for the 
individual to be clean if the home is not clean. Soiled 
clothes should not be left in corners or closets but 




Copyright by Underwood & Underwood 

Fig. 70. — A well lighted and notably kept room 

should be put in baskets or bags made for the purpose. 
Food should not be left on the table and dishes should 
be washed with soap and hot water after each meal. 
The floors should be swept and the woodwork washed 
frequently. Dry dusting should be avoided, as it sim- 
ply sweeps the dust into the air to be inhaled or to 
fall to the floor again. Rugs are preferred to carpets 



HYGIENE OF THE HOME 



187 



as they can be more easily taken up and cleaned out- 
side of the house. Carpets can best be swept if pieces 
of damp papers or damp tea leaves are first spread over 
them. This will prevent the dust from rising into the 
air. Carpet sweepers and vacuum cleaners are valu- 




Fig. 71. — Ineffective protection against- excessive steam 
and humidity 

able helpers to the housekeeper. The woodwork in sit- 
ting rooms, parlors, and bed rooms should be wiped 
with a cloth that has been slightly oiled. Bed linen 
should be changed every week, except in cases of sick- 
ness where it should be changed every day. If beds 
become infected with vermin, as they do sometimes 
even with unusual care, it is necessary to expose the 



188 HEALTH AND EFFICIENCY 

mattress and bedding to the sunlight and to spray them, 
together with the framework of the bed and the wood- 
work of the room, with a preparation made for that 
purpose. This can be obtained in any drug store. 

no. The laundry. The washing of clothing is nec- 
essary for purposes of appearance and for purposes of 




Fig. 72. — Effective protection against excessive steam 
and humidity 

health. The underclothing is in contact with the skin 
and collects oils, dirt, and particles of skin. If not 
removed frequently it may become the breeding place 
for bacteria or vermin. Outer clothing, such as coats 
and skirts, continually gathers dirt and filth and should 
be frequently brushed in the open and hung in the sun- 



HYGIENE OF THE HOME 189 

light. Underclothing should be washed in soap and 
hot water to remove the dirt and to destroy bacteria. 

in. Bathrooms and toilets. Toilets are frequently 
the source of discomfort. They should be continu- 
ously ventilated and should be shut off from the re- 
mainder of the house. Each toilet is provided with a 
mechanism for releasing a current of water and this 
mechanism should be used frequently. Every toilet 
is apt to generate a foul odor, even with the greatest 
care, but this can usually be counteracted by adding a 
few drops of lysol or some other disinfectant to the 
water in the bowl. The floor of the toilet, as well as 
the wood and metal work in it, should be frequently 
washed with soap and water. 

Each family should have its own bath tub and this 
should be frequently cleaned with soap, water, and a 
disinfectant. If it becomes necessary for one to use a 
bath in a boarding house or hotel, it is w r ell to rinse it 
out thoroughly before using. Shower baths are pre- 
ferred to tubs because it is very difficult to keep the 
interior of the latter clean. 

112. Plumbing. The pipes running from sinks, toi- 
lets, and baths, if not cleaned, will attract roaches and 
water bugs, which may in turn distribute disease. It 
is a good plan to rinse such pipes with washing powder 
and to be particularly careful to see that no crumbs 
of food are left around. In spite of the greatest care, 
vermin sometimes creep in, in which case it is necessary 
to sprinkle roach powder freely about the infested parts. 
Open plumbing is preferred to that enclosed in wood- 
work, as it is more accessible to light and air and can 






190 HEALTH AND EFFICIENCY 

be more easily cleaned. Sinks and plumbing can most 
easily be kept clean if the drain pipes are covered by a 
moderately fine filter which will prevent other than the 
smallest particles of waste from passing through. The 
waste which collects in the sink should be removed and 
put in a covered pail, which should preferably be kept 
outside of the house but, at any rate, away from the 




From Bulletin No. 56 — U. S. Hygienic Laboratory 

Fig. 73- — Following the letter but not the spirit of a 
law which did not allow milk to be kept in stables 
after milking, but failed to mention the hoghouse 

kitchen. If the drain pipe does become clogged it can 
usually be cleaned out by fastening the nozzle of a 
short hose to the faucet and passing the other end 
deep down in the pipe. 



HYGIENE OF THE HOME 



191 



113. Garbage. Waste from the table should be put 
in a covered metal can after each meal, and the con- 
tents of the can should be removed from the premises 
frequently. A metal can is better than a wooden one, 
as oils and other liquids are apt to seep through the lat- 
ter, making it filthy. If it is necessary to keep the gar- 




From Bulletin No. 56 — U. S. Hygienic Laboratory 

Fig. 74. — Stable yards of this tvpe are all too common. 
The cows are compelled to wade knee deep in manure 
in order to get into this stable. Much of the filth 
on legs and tail from this source gets into the milk 

bage can on the premises, it is well to sprinkle washing 
powder about it and to keep it enclo:ed as much as pos- 
sible. The can should be kept covered and as little 
liquid as possible put into it. If this is done and if it 
is lined with a sheet of newspaper, the contents will not 
sour in summer or freeze in winter as quickly as other- 



192 HEALTH AND EFFICIENCY 

wise. The garbage should be removed from such a 
pail at least once in twenty- four hours. 

114. Other parts of the house. The cellar is too 
frequently a dumping place for rubbish and a reser- 
voir for water. Under such conditions it becomes a 




Fig. 75. — A sanitary workroom for washing and steril- 
izing milk cans 

breeding place for germs, flies, and mosquitoes and con- 
sequently a menace to health. A cellar should be 
thoroughly drained, since the accumulation of moisture 
favors germ life. Decomposing material should not 
be allowed to remain in a cellar but should be immedi- 
ately removed from the premises or buried. Cellars 
should be well aired and well lighted, and the contents 



HYGIENE OF THE HOME 193 

arranged in some regular order. Dark, damp cellars 
produce a. musty odor, which is apt to pervade the en- 
tire house. In addition they may easily become the 
source of disease. 

Dumbwaiters should not be littered with rubbish or 
garbage. They should be used for the transportation 
of such materials only at stated times of the day and 
the contents should be removed immediately. 

Tubs used for laundry purposes should be kept dry, 
otherwise they may attract vermin and cause the air 
of the room to be saturated with moisture. In this 
way colds or rheumatism may be aggravated. Wet 
wash should not for these reasons remain in the house 
for a longer time than is necessary. Furthermore, wet 
wash, if kept in a tub or basket, will acquire a growth 
of mold in two or three days, if the room is warm. A 
wet wash should be rinsed in clean w r ater as soon as re- 
ceived from the laundry. 

Laundrying should serve two purposes, first, that of 
cleansing, and secondly, that of sterilization. For 
these purposes soap and hot water serve the purpose 
best, except, of course, in the case of colored materials, 
where bleaching must be prevented. In general, there- 
fore, clothes should be thoroughly boiled in soap and 
water in order to render the garments sterile. 

115. The sick room. It is very important to know 
how to properly care for the sick room. Each house- 
hold should have a medicine chest, or something corre- 
sponding to it, containing such remedies of common use 
as peroxide, iodine, epsom salts, castor oil, mustard, 
flaxseed, powdered ginger, and peppermint, each one 



194 HEALTH AND EFFICIENCY 

in a receptacle, properly labeled. Antiseptics, disin- 
fectants, and poisons of all kinds should be in dark 
colored bottles and it is a good plan to have each 
attached to the wall of the medicine chest by 
a string which can be removed when the contents are 
needed. The medicine chest should be high enough 
from the floor to be out of the way of children. 




Fig. 76. — Model workroom in a machine shop 

The linen on the sick bed should be changed each 
day, both to insure cleanliness and to provide comfort 
to the patient. A clean bed is very refreshing. The 
room should be well ventilated and should be free 
from nauseous odors. In very warm weather, an elec- 
tric fan will add greatly to the comfort of the patient. 



HYGIENE OF THE HOME 195 

Persons confined to bed frequently develop bed 
sores. These can be prevented if the general rules of 
cleanliness are observed. The body should be bathed 
with warm water. In some cases it may be necessary 
to do this daily. If the body tends to develop sores in 
spite of this treatment cotton batting, or warm rubber 
bags slightly inflated with air, should be placed under 
the tender parts. 

In preparing a bath for a sick person, attention 
should be given to the temperature of the water. For 
this purpose a bath thermometer should be at hand. 
For general purposes, water of about the temperature 
of the body (98 F.) should be used. In case a hot 
bath is called for, the water should have a temperature 
of over ioo° F. A cold bath can be given with water 
having a temperature under 85 F., depending on the 
kind of bath the patient has been used to and his pres- 
ent condition. 

In cases of colds, grippe, influenza, pneumonia, as 
well as in cases having no more definite symptoms than 
pains, it is frequently advisable to use poultices or other 
forms of applications. A good one is the turpentine 
stupe, made by sprinkling ordinary turpentine on a 
piece of old but clean flannel. The stupe is laid di- 
rectly over the painful area. When a hot water bottle 
is called for, a very good one can be improvised by 
filling an ordinary glass bottle, of any convenient size, 
with hot water, putting a stopper into it and then 
wrapping a towel or other cloth around it. This bottle 
may be of great service in cases of bowel pains, cramps, 
stomach ache, or ear ache. A good poultice can be 



196 HEALTH AND EFFICIENCY 

made by mixing equal parts of flour and mustard and 
then by adding enough hot water to form a paste. This 
should be enclosed in muslin or cotton cloth and gently 
placed on the body. 

Great care should be taken to cleanse and disinfect 
the sick room. This can be done, in part, by providing 
proper ventilation and, in part, by frequently changing 
the bed linen, which should later be thoroughly washed 
in soap and hot water. In case of infectious disease, 
like typhoid, some disinfectant — lysol, for instance — 
should be added to all wastes from the person's body 
before they are emptied into the sewer. After the pa- 
tient has recovered, the woodwork of the room should 
be thoroughly washed with soap and water and the air 
and walls may be disinfected by burning formaldehyde 
candles. 



PART III 
COMMUNITY HYGIENE 



CHAPTER XIV 
FOOD DISTRIBUTION 

116. Sources of milk supply. Milk is one of the 
most valuable of foods since it contains all the con- 
stituents necessary to sustain life, namely, fuel foods 
(sugar and fat) and building or repair foods (pro- 
teins), mineral substances, water, and vitamines. In 
cases of tuberculosis and in the case of those who 
have a tendency toward the disease or who grow 
quickly, or are thin, pale, and languid, milk is indis- 
pensable. The milk supplies fat to the tissues, render- 
ing them more resistant to disease. It is essential, 
however, that the milk be pure and undiluted. It is 
the practice among, some farmers to add water to the 
milk in order to increase the quantity. When one 
buys a quart of such milk he gets less of the real milk 
ingredients than he would if it had not been tampered 
with. Among other farmers it is the practice to re- 
move some of the cream, the fat of the milk, and to 
sell the milk in that condition or to add a thickening 
substance to replace the cream. Great care should be 
taken, therefore, in the se 1 :ection of a milk dealer. In 
case one is suspicious of the composition of the milk, 
a sample should be taken to the Board of Health for 
examination, or the matter quietly reported to them 
for investigation. 

199 



SCIENTIFICALLY 
CALLED 



Total ^ 
Solids 



Waters 



ORDINARILY 
CALLED 



> Cream 




Skim 
Milk 



(From Smith, The World's Food Resources.) 

Fig. yy. — The contents of a bottle of milk 
200 




From Bulletin No. 56 — U. S. Hygienic Laboratory 

Fig. 78. — Filthy walls, floors and ceilings. A condition 
frequently met with in old barns. Ceilings full of 
cobwebs and dust. Walls and floors show little 
evidence of cleaning. Clean milk can not be pro- 
duced is such a place 

201 



202 



HEALTH AND EFFICIENCY 



Milk is easily contaminated by disease bacteria, espe- 
cially those varieties producing typhoid, tuberculosis, 
and scarlet fever. Cattle are frequently infected with 
tuberculosis and the bacteria of this disease may be 
transmitted to human beings by means of meat or milk. 
While it is not believed that tuberculosis among adults 




From Bulletin No. 56 — U. S. Hygienic Laboratory 

Fig. 79- — Dirty flanks. A common condition in winter. 
Flanks become caked with manure, which there is 
often no thought of removing. This is the source of 
most of the dirt found in milk in winter time 

is transmitted in this way, it is definitely known that 
tuberculosis among children is. What, then, can be 
done to give children this indispensable food and yet 
safeguard them from danger? The remedy lies in a 
careful supervision of the supply. Fortunately, there 
is a method, devised by the celebrated German physician 



FOOD DISTRIBUTION 203 

Koch, called the tuberculin test, which, when applied to 
a cow, will tell whether she has tuberculosis bacteria 
growing in her body. This test is used very generally 
by Boards of Health to determine whether it is safe to 
allow r the use of milk from cattle under their super- 
vision. This method should be extended and only milk 




From Bulletin No. 56 — U. S. Hygienic Laboratory 

Fig. 80. — A clean, well lighted stable and healthy cows 

are important elements in the production of 

good milk 

coming from tuberculin tested cows should be used as 
food. 

Great care should be taken with the quarters where 
cattle are confined. The barn should be warm and, 
whether it is an old barn or a new one, it should be 



204 HEALTH AND EFFICIENCY 

kept clean, The author recently visited a barn over 
fifty years old. There were four cows in it and he has 
seldom seen cattle kept in such comfort. The stalls 
were bedded with hay that could not be used as food 
and the manure was removed regularly. The stalls 
were well lighted and the room was well ventilated by 
means of adjustable windows. The owner of this barn 




From Bulletin No. 56 — U. S. Hygienic Laboratory 

Fig. 81. — Shows a clean barn-yard and well lighted barn 

was recently given a First Prize by the Massachusetts 
State Board of Health for the sanitary way in which 
he kept his cattle. 

The body of a cow giving milk should be clean, espe- 
cially about the udders. The pails into which the milk 
is drawn should have been thoroughly washed and aired 
and the milker should have washed his hands before 



FOOD DISTRIBUTION 205 

milking. Only by taking precautions such as these can 
the milk supply be guaranteed. On some farms where 
there are a large number of cows to be milked, this 
work is done by means of electrically run appliances. 
This method, of course, decreases the danger of infec- 
tion. After the milk is drawn, it should be strained 
and put in a cool place. If it is to be cooled by placing 
the cans in wells, the well water should first be exam- 
ined to make sure that it contains no typhoid bacteria. 
The wastes of persons having this disease, as well as 
the wastes of typhoid " carriers," contain typhoid bac- 
teria and if such wastes are allowed to get into the 
water supply, serious damage may result. This some- 
times happens, for instance, where a toilet is located 
so near to a well that it drains into the well or where 
the w r ell is loosely covered with boards and typhoid- 
infected waste is washed in by rain water or carried 
there on dirt clinging to the soles of the feet. 

117. Guarding the distribution of milk. As milk 
stands, the bacteria in it multiply very rapidly under fa- 
vorable conditions. To inhibit this growth, the milk 
must be kept at a low- temperature. It may be neces- 
sary to pasteurize the milk, also. This is done by sub- 
jecting the milk to a temperature of 142-145 F. for 
at least thirty minutes. In this way, the milk can be 
kept longer without souring and the possibility of dis- 
ease transmission is very much diminished. Even if 
milk has been pasteurized, it should be put on ice as 
soon as possible and kept there until ready to use. It 
is safer to use bottled milk than " loose " milk, since 
there is less danger of bacteria getting in from the out- 



206 HEALTH AND EFFICIENCY 

side. " Loose " milk .can be used for cooking, as the 
heat will usually kill the bacteria. 

Babies, in .particular, need fresh, clean milk and 
parents will do well to leave no stone unturned to get 
it. It will frequently be found that persons, both 
young and old, with whom milk does not seem to agree, 
will be able to use it if the milk comes from one cow, 
or if a cereal like barley water or oatmeal is mixed 
with it. 




From Bulletin No. 56 — U. S. Hygienic Laboratory 

Fig. 82. — Types of milk pails. Narrow-top pails are the 

best 

It is impossible, with ordinary methods of handling, 
to get milk free from bacteria. The Department of 
Health of New York City, which has the highest sani- 
tary standards of any department in the world, accepts 
as of the highest grade, milk containing up to 60,000 
bacteria in each cubic centimeter (half thimble full), 
Since bacteria multiply very rapidly at room tempera- 
ture, it is necessary to take many precautions in order 
to keep the number as low as possible. Milk may be 



FOOD DISTRIBUTION 



207 




From Bulletin No. 56 — t/. S. Hygienic Laboratory 

Fi g< g 3 — Good type of milking suit and pail 

made nearly sterile by boiling for five to ten minutes. 
The objections to this are that the protein material is 



208 



HEALTH AND EFFICIENCY 



hardened and some of the mineral substances are pre- 
cipitated, making the milk less digestible. This method 
has been superseded by pasteurization. When done on 
a large scale, the milk to be pasteurized is run in a 
thin stream over a heated metal surface. If the method 
is carefully followed out, all disease bacteria, such as 




From Bulletin No. 56 — U. S. Hygienic Laboratory 



Fig. 84.— Children wrongly intrusted with the important 
work of washing milk bottles 

those causing ' typhoid and tuberculosis, together 
with many of those which cause souring, are killed by 
the process. Milk may be pasteurized in the home by 
means of an apparatus consisting of a tin pail with a 
perforated cover, and containing a wire basket into 
which may be put a number of open bottles containing 



FOOD DISTRIBUTION 



209 



the milk. The water in the pail is heated to boiling, 
the wire basket then lowered so that the bottoms of the 
bottles nearly touch the water, where they are allowed 
to steam for ten minutes. At the end of this time, the 
bottles are covered and the steaming continued for fif- 
teen minutes longer. The bottles are then removed, 
immediately cooled, and put on ice. 



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From Bulletin No. 56 — [7. S". Hygienic Laboratory 

Fig. 85. — Dairy room in cellar, under stairs. No light, 
no ventilation. 

In order to prevent decomposition, all milk, even 
though pasteurized, must be kept cool by a temperature 
at least as low as 50 F. 

It is necessary to keep flies from milk as these insects 
readily introduce bacteria through the filth on 



210 



HEALTH AND EFFICIENCY 



their legs. Consequently, it is necessary to have doors 
and windows properly fitted with screens and to kill 
all flies that do get into the house. It is necessary also, 
to wash the top and sides of the bottles before using 
them, as cats and dogs frequently lick drops of milk 
from the tops of the full bottles, and the eggs of tape- 
worms may be thus introduced. 





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From Bulletin No. 56 — U. S. Hygienic Laboratory 

Fig. 86. — A good type of inexpensive milk house 

The Department of Health of New York City sends 
inspectors to all farms where milk is produced to be 
sold in that city. Dealers in milk are compelled to 
comply with the Department of Health regulations, 
otherwise their licenses are taken away from them. 
The sanitary stabling of cows is required, together 
with cleanliness on the part of the milkers. Milk must 



FOOD DISTRIBUTION 



211 



be received in pails with small openings and immedi- 
ately strained and kept at a temperature not higher 
than 50 F. until used. All employees of concerns 
handling the milk must be free from transmissible dis- 
eases and all wholesale and retail establishments are 




Fig. 87. — A model milk and storage room, where certified 
milk is produced, showing enameled walls and 
cement floors. Note machine for putting caps on 
bottles 

under the constant supervision of the Health Depart- 
ment. In addition to a staff of inspectors, the Depart- 
ment has special laboratories for the bacteriological and 
chemical examination of milk samples sent in by in- 
spectors. 

118. Sale and distribution of meat, vegetables, and 



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216 



HEALTH AND EFFICIENCY 



fruit. Meat, fish, and eggs, unless carefully guarded, 
spoil readily — that is, the bacteria of decay attack 
them and make them unfit for food. The methods of 
preserving these foods most commonly used are cool- 
ing, salting, and drying. Bacteria do not thrive at low 
temperatures and, consequently, if food is kept on ice 
it will not spoil readily. Food in a cold storage plant is 




From Bulletin No. 56 — U. S, Hygienic Laboratory 
Fig. 88. — Good pump surroundings 

thoroughly frozen and may be usable even after sev- 
eral months. The sale of such food is usually super- 
vised by Departments of Health in order to prevent 
food that has been kept too long being placed on the 
market. In most up to date cities, dealers selling cold 
storage food must post a conspicuous notice to that ef- 



FOOD DISTRIBUTION 217 

feet, so that cold storage food will not be sold for fresh 
food. Pork, beef, eggs, and fish can be preserved by 
putting them in brine. A flank of beef that costs 
twenty cents a pound when sold in the market as corned 
beef, can be bought for half the price if purchased 
fresh and in pieces of fifteen or twenty pounds. It can 
be put in brine and kept for weeks, changing the brine 
as often as necessary. 

Eggs can be bought in quantity when they are 
cheapest and put in a mixture of waterglass (one part 
of waterglass to six parts of water) where they will 
keep for months. Such eggs are perfectly good for 
cooking purposes and are at least as good as many eggs 
sold in stores and restaurants as fresh. 

Many fruits and vegetables can be purchased in sea- 
son and dried. The drying of such foods as squash, 
apples, pumpkins, etc., is an old art and one that 
should be revived both for dietary and economic 
reasons. Bulletins describing some of these methods 
of preserving foods can be obtained from the United 
States Department of Agriculture at Washington and 
from State Experiment and Agriculture Stations. 

Food should be kept well covered, as dust is con- 
tinually falling from the air and flies, whose feet are 
frequently covered with filth, will be attracted by it. 
Vegetable and fruit dealers can protect their wares by 
putting them in glass or mesh covered cases. Meat or 
fish that has the slightest suggestion of decay should 
not be used. If it is discolored or has a bad smell, it 
is not safe to eat, as ptomaine poisoning may result. 



218 



HEALTH AND EFFICIENCY 




GD E do 



Fig. 89. — Showing relation of milk routes to typhoid 
fever cases during the epidemic at Stamford, 
Conn., 1895. (Diagram I) 

This disease is caused by germs forming poisonous sub- 
stances out of the meat. Ptomaine poisoning not in- 



FOOD DISTRIBUTION 



219 



SEE 





r-.- 1 — 1 



<a e m e 



o 



N 



m 



Fig. 90. — Showing* relation of milk routes to scarlet 
fever cases during outbreak at Norwalk, 
Conn., 1897. (Diagram II) 

frequently comes from canned meats and fish like lob- 
ster and crab. Furthermore, ice cream, made from 



220 



HE\LTH AND EFFICIENXY 






Tnilton 






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Fig. 91. — Showing relation of milk routes to typhoid 
fever cases during the epidemic at Stamford, 
Conn., 1895. (Diagram III) 



FOOD DISTRIBUTION 221 

pasteurized milk, may ferment and produce no notice- 
able alterations in taste but dangerous poisons (pto- 
maines ) may be formed from it. 

119. Water supply. The water from a well, if it is 
carefully protected, is the purest and best water avail- 
able. The well should not be located near a barn or 
privy or near the edge of a pond, but should be set oft 
by itself in sandy soil with the top well protected. A 
cover of a few loose boards is not sufficient,, as dirt, in- 
sects, and larger animals continually drop in. For this 
reason, it is a good plan to build a wall or fence around 
the well or, at least, to put over it a close-fitting cover. 

Water from a stream or river should not be used 
until it has been examined. Large towns and cities 
are now commonly supplied with water from specially 
constructed reservoirs. Water from this source is fil- 
tered through sand, to remove solid particles, and is fre- 
quently examined for the presence of disease-producing 
bacteria. 



CHAPTER XV 
DISPOSITION OF WASTES 

120. Wastes from the kitchen. These are com- 
monly made up of vegetable and animal matters which 
decay quickly and consequently attract such insects as 
flies and roaches. These wastes should be kept cov- 
ered in water-tight containers, to prevent leakage, and 
should be removed from the premises frequently. If 
no other means of removal is at hand, they should be 
burned or buried. In many communities these wastes 
are collected and fed to swine. In other cases, the) 
are used as fertilizer, or such vegetable material a^. 
fruit peelings is separated out for the purpose of mak- 
ing cheap perfumes. 

121. Wastes from the body. Body wastes fre- 
quently contain such disease bacteria as those causing 
typhoid or such animal parasites as those causing diar- 
rhea or hookworm disease. Since flies are attracted 
by wastes, disease germs are quickly transmitted by the 
insects from the filth to the table. Communities not 
having sewage systems find it necessary to provide in- 
spection of toilet facilities. Privies should be enclosed 
and, in summer time, the windows should be screened 
to keep out flies. Dirt or sawdust mixed with chloride 
of lime should frequently be used to fill in. Campers, 
especially, should take precautions in such matters as 

222 



DISPOSITION OF WASTES 223 

the disposal of wastes and the source of the water sup- 
ply. The floor around toilets in houses should be 
cleaned every day and at least once a week the bowl of 
the toilet should be cleaned with hot water to which 
washing powder has been added. Special, long handed 
brushes are available for this purpose and these should 
be well rinsed after using and should then be hung out 
of doors, preferably in the sunshine. The condition of 
a toilet will be much improved if, after washing, a disin- 
fectant such as creolin is added. 

122. The disposal of sewage. In the case of cities, 
sewage is usually carried from the houses by strong 
currents of water which empty into rivers or into large 
sewage beds. If the sewage empties into a river, puri- 
fication is carried on by bacteria. Bacteria decompose 
the wastes into harmless substances. The water under 
such conditions should not be stagnant but, on the 
other hand, should be flowing freely. The foul odors 
coming from rivers into which sewage empties usually 
arise because the water is not moving fast enough. 
When water flows fast, bubbles of air are caught in it 
and oxygen, which is essential for purification, dissolves 
in the water. 

In order to avoid the foul odors that sometimes arise 
from sewage emptying into ponds or rivers, some com- 
munities build sewage beds. These may be made up 
partly of large tanks, to the bottom of which much of 
the solid matter sinks; and of screens, to sift out a 
part of the sewage ; and, finally, sandy or rocky beds, 
over which the sewage flows and is purified. 

123. Removal of wastes from the streets and 



224 



HEALTH AND EFFICIENCY 



parks. Most communities now have methods for re- 
moving wastes from the streets. Communities border- 
ing on the ocean usually make provisions for the col- 
lection and disposal of seaweed and dead fish. Wastes 
from horses and cattle, the bodies of animals, apple 
cores, orange peelings, etc., are usually collected sys- 




Copyright by Underwood & Underwood 
Fig. 92. — Street cleaner properly protected 

tematically and burned or buried. Community pride 
can usually be estimated by the condition of the streets. 
Papers and remnants of lunches should not be left 
on the ground in parks but should be put in receptacles 
which are usually found at convenient places for this 
purpose. 



CHAPTER XVI 
SOME ANIMAL ENEMIES OF MAN 

124. Worms that produce disease. It is a common 
practice in Europe and in some parts of this country 
to eat raw sausage made from pork. It is estimated 
that thousands of pounds of pork roll (roulade) 
are eaten in this country during the winter months, 
while during the warm weather, " summer sausage " 
is consumed in large quantities under the name 
of " salame " and " cervelate." This practice of eat- 
ing raw pork is a very dangerous one, as over 
two per cent, of all hogs are infected with a small 
worm, called the trichina. The eggs of this worm may 
be taken into the human body by eating pork and, if 
the meat has not been thoroughly cooked, they may 
develop there into adult worms which locate in the 
muscles and produce inflammation and pain. Many 
cases of supposed rheumatism have undoubtedly been 
due to this parasite. Illness, appearing a few days 
after raw pork has been eaten, followed by pains in the, 
muscle, are the symptoms of the disease. The Depart- 
ments of Health in most of the large cities require phy- 
sicians to report cases of this disease. If people avoid 
raw pork and raw meat generally, they will have no 
cause for worry. 

Another worm which may become parasitic in man 

225 



226 HEALTH AND EFFICIENCY 

and produce distressing symptoms is the tape worm. 
There are many varieties of this worm, some a few 
inches in length, when full grown, while others reach 
a length of several feet. Tape worms twenty-five feet 
in length have been removed from the intestines of 
man. These worms may gain entrance to the human 
body through eating incompletely cooked beef, mutton, 
pork, or fish, and through handling dogs and cats, or 
through fleas and other insects that infest these ani- 
mals. Most varieties of tape worm occur in the flesh 
of animals used by man as food. When such meat is 
eaten raw or incompletely cooke'd, the young tape 
worms may attach themselves to the sides of the intes- 
tine, where they absorb the digested food needed by the 
tissues of the body and where they give out poisonous 
substances which may be absorbed and distributed over 
the body. One variety lives in the intestines of dogs 
and cats and lays its eggs there. These may be trans- 
ferred to the human body when the animal licks the 
face or hand or when its wastes get on objects such 
as carpets or dirt, which later come in contact with 
the human body. Another form passes a part of its 
existence in the body of the dog flea. A bulletin pub- 
lished by the United States Department of Agriculture 
contains the following: 

" When flea infested or lousy dogs are allowed un- 
warranted privileges in the house, permitted to put 
their paws on the table during meals, to eat from the 
same dinner plates and saucers, to lick the baby's face 
and the children's candy, to sleep at the foot of a per- 
son's bed or on a pillow near a person's head, the 



ANIMAL ENEMIES OF MAN 227 

chance of a flea landing unperceived in food that will 
hold and conceal the flea, the chance of the flea getting 
to the baby's mouth or adhering to the sticky candy 
which the child eats with no regard to incidental con- 
tamination is very good." 

" Hookworm disease," very common in the Southern 
States, is characterized by laziness, emaciation, pro- 
truding stomach, a local irritation of the skin, and, 
frequently, by a craving for such substances as dirt, 
shavings, etc. It is caused by a small worm which gains 
entrance to the human body through drinking water 
or by contact with moist soil, as when one goes bare- 
foot. The worm clings to the intestinal wall, where it 
feeds on blood which it sucks out of the tissues. The 
United States Public Health Service is at work try- 
ing to stop the disposal of human wastes in water used 
for drinking purposes and on the ground where others 
may walk. The eggs of the hookworm are thrown out 
of the body with the intestinal wastes and, months 
later, may gain entrance to the circulation of another 
person through the pores of the skin. 

Round worms and pin worms frequently occur in 
the intestines of man, the latter, especially in children. 
They may be transmitted by flies or other insects or 
through dirt. For that reason the hands of children 
should be kept clean and uncooked food be washed 
wherever possible. Preference in trade should be 
given to merchants who keep food clean and protected. 

125. Lice that may infest the human body. Many 
persons, especially school children, become infested 
with head lice, even when the greatest care has been 



228 HEALTH AND EFFICIENCY 

taken. They may get into the hair when children are 
seated near together, or when travelling in cars, or 
they may go from one hat to another, or be contracted 
from combs, brushes, beds, couches, or chairs. Each 
insect has a sucking apparatus which he thrusts through 




Photograph by Underwood & Underwood 

Fig. 93. — Examining the baggage of immigrants for the 
presence of vermin which may spread typhus 

the scalp, producing intense irritation and resulting in 
scratching. The scalp may finally take on a fetid odor. 
The tiny eggs of the insect, commonly called " nits," 
may be seen attached to individual hairs. The treat- 
ment consists in washing the hair thoroughly with a 
mixture of equal parts of olive oil and kerosene just 



ANIMAL ENEMIES OF MAN 229 

before going to bed and of wrapping a towel about 
the head for the night. The washing should be re- 
peated at intervals of three days until the head is clean. 
Care should be taken to keep away from any flame 
while kerosene is on the head. School children should 
be very careful to keep their hats and wraps out of 
contact with those of children of unclean habits and 
should ask to be seated separate from such children. 
Suspected cases of head lice should be reported to the 
teacher. 

Body lice produce intense irritation and also fre- 
quently transmit typhus fever. The latter has re- 
peatedly been the case during the Great War. The 
lice live in the seams and recesses of clothing and are 
found on those who do not bathe frequently and who 
rarely change their garments. Persons infested with 
these lice should have their clothing freed from the 
vermin by subjecting it to intense heat and by washing 
the body thoroughly with soap and hot water. Houses, 
school rooms, cars, etc., can be freed from the pest by 
the use of poisonous vapors. The cooperation of the 
local Department of Health can always be secured in 
such matters. 

126. The common fly. Public Health Leaflet No. 
8, entitled " Various Vermin which Menace Health and 
Comfort " and published by the Bureau of Public 
Health Education of the Department of Health, City 
of New York, says : 

" It is very evident that there are excellent reasons 
for suspecting the fly of carrying bacteria. Born in a 
dunghill, it spends its days flitting between the sugar 



230 



HEALTH AND EFFICIENCY 



basin, milk-pan, and any faecal or other decomposing 
matter available. Its hairy, sticky feet, and its habit 
of regurgitating the contents of the crop, and defecat- 
ing at frequent intervals make it an excellent agent for 
diffusing any bacteria it may pick up. 




Fig. 94. — The common house fly 

" That it thus carries infectious material has been 
abundantly proven. Flies have been allowed to walk 
over cultures of bacteria and, afterwards, over sterile 
plates of culture medium. A rich crop of germs always 
developed in their footprints. Proof has also been given 
that bacteria, taken in in a fly's food, are passed out 



ANIMAL ENEMIES OF MAN 231 

again in its saliva, the material it regurgitates from its 
crop, and in its dung. 

" These last mentioned modes are more important 
than even the carriage of bacteria upon the fly's legs. 
Many disease-producing bacteria would soon die from 
lack of moisture on the outside of the insect, but within 
they live much longer. One investigator found ty- 
phoid and other germs in the intestinal contents of flies 
•six days after they had fed on material containing the 
organisms. 

" There are numerous instances in which the organ- 
isms causing cholera, typhoid fever, tuberculosis, an- 
thrax, and bubonic plague have been recovered from 
the dejections of flies, which w r ere captured in the 
neighborhood of cases of these diseases. The spread 
of contagious eye diseases in hot countries has been at- 
tributed to the agency of flies in carrying special germs 
(the Koch- Weeks bacillus and the gonococcus) from 
eye to eye. These eye diseases are particularly preva- 
lent in Egypt, a country M famous for flies " since the 
time of the Pharaoh, said to have been punished 
through the agency of Moses by various plagues, one 
of which was of flies. Even the Promised Land was 
so troubled by these insects that one of the terms ap- 
plied to the devil there was Beelzebub, which meant 
lord of flies. 

What the Department of Health Does to Prevent 

Flies 

" Stable owners are compelled to have all manure re- 
moved from stables daily, or to have such manure 



232 HEALTH AND EFFICIENCY 

pressed in tightly covered receptacles, and removed at 
least twice weekly. They are required to provide a 
sufficient water supply to permit of regular flushing 
down of the stable and, generally, to prevent all fly 
breeding therein. For this purpose, they are informed 
of the virtues of borax and of some other substances 
that may be applied to the manure to prevent fly breed- 
ing therein. 

" Contractors removing manure from stables are re- 
quired to provide tight vehicles with covers, to prevent 
the dropping of manure on the street. 

" Railroad sidings, upon which cars stand for the 
loading of manure, are required to be cemented, graded 
to properly trapped sewer or cesspool connected drains, 
and flushed down at the termination of each day's load- 
ing. If the manure be loaded upon scows at the water 
front, the regulations of the Department require the 
contractor to provide dumping boards, curtains, etc., 
to prevent the manure falling into the water or upon 
the dock. At the termination of each day's loading, 
the dock has to be cleaned. It is generally required to 
remove these cars or scows daily. In case of inter- 
ference with such daily removal by strikes or other 
controlling events, the sanitary inspectors see to it 
that borax or lime is sprinkled upon the manure to 
prevent fly breeding. 

" Accumulations of various decaying organic mate- 
rials offer excellent breeding places for flies. Conse- 
quently, the garbage of the city, from household to its 
final disposition, is a possible source of fly production. 
The householder is required to provide tightly covered 



ANIMAL ENEMIES OF MAN 233 

metal receptacles for garbage and to place these on the 
street, close to the building line, for removal by the 
carts. After emptying, these cans are to be cleaned, 
preferably with hot water and soda. 

" Through cooperation with the Department of Street 
Cleaning, the dumps for garbage are cleaned regularly. 
Disinfectants are used freely on the dumps and on the 
garbage on the scows, in order to prevent fly breeding. 
The loaded scows are removed at regular intervals to 
the garbage disposal plants. 

" It is unfortunately true that some people prefer to 
throw their garbage into vacant lots or upon property 
adjoining their premises, rather than to place it in con- 
tainers set apart for that purpose. This practice 
causes considerable labor to the Department of Health, 
which requires the cleaning up of such accumulations, 
and unnecessary expense to the owners of the prem- 
ises affected. 

" In the outlying districts of the city, the lack of 
sewers is responsible for a dangerous health menace in 
the shape of privy vaults. The Department of Health 
is insistent in its demands upon owners to maintain 
these in as cleanly a condition as possible, and requires 
thorough screening of the contents of the vault and all 
openings to the privy structure itself, so that flies may 
not gain access. 

' Vehicles and apparatus used for the removing of 
cesspool waste, contents of privy vaults, garbage, fat, 
bones, etc., are required to be cleaned and disinfected 
after each use, and stored up so as not to be a nuisance 
or to permit of fly breeding. 



234 HEALTH AND EFFICIENCY 

" The camp colonies at the seashore present a difficult 
problem that requires constant attention on account 
of the complex population and the free life of the in- 
habitants and their visitors. Sanitary inspectors, aided 
by sanitary police, patrol these camps constantly, pre- 
venting accumulations of garbage or other organic ma- 
terials, unclean cans and bottles, overflowing cesspools, 
and all other conditions permitting of fly breeding or 
furnishing feeding places for flies. In those camps 
that have no sewer connections, the can system for 
disposal of human waste is in vogue. The cans are 
screened to prevent the entrance of flies, and are reg- 
ularly emptied and disinfected by licensed scavengers 
under the supervision of the Department of Health." 

Ways to Destroy and Prevent Flies 

" Sticky fly paper, which catches but does not poison 
flies, and fly-traps, are both efficacious in destroying 
these insects. Fly poisons, usually sold in the form of 
brown paper sheets saturated with sodum arsenite, are 
very serviceable. Other effective poisons are a i per 
cent, solution in water of either formalin or sodium 
salicylate (dissolves easily in hot water) — I per cent. 
of either of these substances may be obtained by using 
approximately three teaspoonfuls to a pint; either can 
be purchased in any drug-store. The addition of 
either milk or water does not make these substances 
more attractive to flies. If fly poisons are used they 
should not be left where children can have access to 
them. 



ANIMAL ENEMIES OF MAN 235 

" The familiar practice of swatting flies is the best 
way to rid a room of a few of the insects, when the 
access of more has been provided against, as by effec- 
tive screens. 

" Flies should be kept out of the dwelling altogether, 
particularly should the kitchen and dining room be 
free from these dangerous pests at all times. Neither 
should flies be allowed to crawl over the face of sleep- 
ing people, particularly babies. Effective screening of 
dwellings is absolutely necessary. 

" It is very important that all body discharges, such 
as sputum, be kept from flies ; and that they be kept 
out of w r ater closets, privies, and sick rooms, in order 
to prevent the spread of germs from these places. 

" All foodstuffs eaten without further cooking or 
washing, such as bread, cake, candy, fruit, etc., must 
be protected from flies. No one should patronize es- 
tablishments, such as bakeries, candy, or fruit stores, 
or especially restaurants, which tolerate these nasty 
insects. Screening of windows, doors, and, if neces- 
sary, netting over such of these wares as might be ex- 
posed within a shop, together with the other anti-fly 
measures mentioned, will accomplish the desired end. 

'* No decomposing refuse, such as dung, garbage or 
dead animals, should be permitted to lie around any- 
where exposed to flies. " 

127. The bedbug. It has been known that bubonic 
plague and several tropical diseases are spread by the 
bedbug. This insect sucks in the germs from the body 
of a person infected with one of these diseases and 
later gives them out to the tissues of a well person. 



23G HEALTH AND EFFICIENCY 

The bedbug is brown in color, has a flat body, about an 
eighth of an inch long, gives off a disagreeable odor, 
and frequently leaves black spots or traces on the wall, 
woodwork, or bedding. They may live for months or 
years without eating. They commonly hide in the 
seams of mattresses, in the cracks of wooden beds, or 
of wall paper, under the molding or, in fact, in any 
crevice in the room. To rid beds or rooms of these 




Fig- 95- — A mosquito marsh before drainage 

vermin, crevices may be sprayed with a commercial 
product, obtainable at drug stores. If the entire apart- 
ment or house is infected, it may be necessary to burn 
sulphur. In moving into a new apartment it is well to 
spray the rooms with an anti-bedbug liquid. Wooden 
beds should not be used because of the concealment 
which they offer to the vermin. For the same reason 
it is best to have painted walls rather than papered. 



ANIMAL ENEMIES OF MAN 237 

128. Mosquitoes. The females of many species of 
mosquitoes feed on human blood and are consequently 
the cause of considerable irritation. In addition, one 
species transmits from one person to another a tiny 
one celled animal which causes malaria, while another 
species transmits yellow fever. 

The malaria carrying mosquito is brown in color, and 
has four dark brown markings on each wing. When 
it alights, the body is pointed upward as contrasted 
with the horizontal position assumed by the body of 
the harmless variety. It passes the winters in stone 
walls, crevices of trees, caves, and cells. 1$ lays its 
eggs on the surface of stagnant fresh water in the 
spring. 

When the malaria carrying mosquito bites a person 
whose blooa contains the germs of malaria, some of 
these may be sucked up with the blood. These germs 
of malaria are distributed to all parts of the mosquito's 
body, some going to the glands which secrete the saliva. 
When the mosquito bites another person, some of the 
germs may go out with the saliva and develop in the 
blood of that person. 

The yellow fever mosquito is common in our South- 
ern States and in South America. It was found to be 
the carrier of yellow tever by an American Army com- 
mission consisting of Drs. Carrol, Reed, Lazear, and 
Agramonte. The success of their labors is largely 
due to the bravery of two assistants — Kissinger and 
Moran — who volunteered to allow themselves to be 
bitten by the mosquitoes suspected of carrying the 
fever. 



238 



HEALTH AND EFFICIENCY 



There are not very many natural enemies of the mos- 
quitoes. Dragon flies (darning needles), small fish, 
such as minnows and killie fish, beetles, and some in- 
sects feed on them. In some cases they eat one another. 
In order to free a community from the pests it is nec- 
essary to find their breeding places. If it is in rain 
barrels, eave troughs, cans, or buckets, these must be 
emptied before any relief can be expected. If it is in 




Fig. 96. — Method of draining a marsh 

ditches, these must be drained or filled in. If it is in 
ponds or slow moving streams, these should be stocked 
with fish which feed on the young mosquitoes. If it 
is in large pools that cannot be drained, thes^ should 
have added to them kerosene oil, which will spread out 
as a film over the surface of the water. 



CHAPTER XVII 
COMMUNITY CONTROL OF DISEASE 

129. Isolation of infectious diseases. Some diseases 
for instance Apoplexy and Bright's Disease, are 
not transmitted from one person to another. Well 
persons may associate with those having such diseases 
without fear of contracting them. There are, on the 
other hand, some, other diseases, which are easily trans- 
mitted from one person to another. Scarlet fever, 
smallpox, whooping cough, diphtheria, tuberculosis, 
typhoid, and measles are examples of this kind. It 
is not safe for well persons to associate with persons 
having these diseases. A person having tuberculosis, 
if he must live at home, should be isolated from the 
rest of the family, otherwise the disease may infect the 
entire household. A tuberculous patient should have 
separate sleeping quarters, should not shake hands or 
kiss other members of the family, and should have his 
own table dishes, which should be cleaned separately 
from those of the other members. Children having 
whooping cough, scarlet fever, or measles, or any of 
the other diseases mentioned, should live in a room by 
themselves until they are entirely well. Parents 
should not allow their children to play with those who 
are recovering from or in whose families any of these 

239 



2W 



HEALTH AND EFFICIENCY 



diseases are present. "An ounce of prevention is 
worth a pound of cure." 

130. General symptoms of infectious disease. 
Since most children, at some time, are exposed to in- 
fectious diseases, it is well always to have in mind the 
signs or symptoms which indicate their early stage. 
Some of the symptoms are so simple that they are apt to 
be overlooked, and may include any of the following: 




Fig. 97. — A marsh after drainage 

malaise (indisposition), running nose and watery or in- 
flamed eyes, restlessness, fever or chills, coughing or 
sneezing, rash on the face or body, vomiting, and diar- 
rhea. If any combination of these symptoms is pres- 
ent the child should be undressed and put to bed and 
a physician sent for immediately. 

131. Immunization. Some persons never have tu- 
berculosis or smallpox or typhoid for the reason that 
they are, from birth, incapable of contracting the dis- 



COMMUNITY CONTROL OF DISEASE 241 

















1 


US 





Fig. 98. — This granite worker surfacing stone is shielded 

by a wire mask which, however, fails to protect 

his eyes against fine particles of stone 

ease because their blood offers some unusual resistance 
to the germs causing it. Again, those who have had 
measles or whooping cough are generally immune to 



242 



HEALTH AND EFFICIENCY 



the disease for the rest of their lives. Physicians have 
taken a suggestion from Nature and now use sub- 
stances artificially to produce immunity. For instance, 
the covvpox vaccine, used in vaccination against small- 
pox, is one of these ; another is the vaccine used against 




Fig. 99- — A stone cutter cutting stone in the rough by 
means of a pointed tool and a machine which is 
operated with compressed air. The strong blast of 
air keeps the stone clean, but gives rise to a great 
amount of dust 



typhoid ; and still another is the antitoxin used against 
diphtheria. 

The use of smallpox vaccine has been described in a 
preceding chapter. Diphtheria antitoxin is obtained 
from a horse. The diphtheria germs produce a poi- 



COMMUNITY CONTROL OF DISEASE 243 

sonous substance called a toxin, which is injected into 
the body of a healthy horse. This stimulates the tis- 
sues of the horse so that a counteractive substance 
called an antitoxin is produced. Some blood is drawn 
off from the horse and the serum is separated. This 
serum, when injected in carefully graded doses into 
the body of a diphtheria patient, has the power, by vir- 
tue of the antitoxin that it contains, of counteracting 
the toxin produced by the diphtheria bacteria in the 
body of the diphtheria patient. 

132. Sanitaria and isolation hospitals. In order 
to control such infectious diseases as tuberculosis, small- 
pox, and leprosy, many States provide institutions 
where patients having these diseases may go. For in- 
stance, there are tuberculosis sanitaria built on high, 
dry areas and provided with plenty of fresh air and 
sunlight. Treatment for tuberculosis can usually be 
secured, free of charge, by those who cannot afford to 
^ay. The best treatment medicine knows is given to 
patients suffering with this disease, and there is no 
reason why any such person should hesitate to ask his 
physician to secure admission to one of these hospitals. 
Those who have any of the symptoms of the disease 
such as cough, loss of weight, malaise, fever, 
night sweat, loss of appetite, should consult a physician 
at once, as it is easy to arrest tuberculosis if the disease 
is taken in time. 

In addition to tuberculosis sanitaria there are isola- 
tion hospitals for smallpox and leprosy. The patients 
in these institutions live by themselves, their clothing 
is disinfected, and the wastes from their bodies, are des- 



2TI 



HEALTH AND EFFICIENCY 



troyed. These methods, together with proper treat- 
ment keep these two diseases from becoming epidemic. 
133. Inspection of barber shops. Several infec- 
tious diseases, some of them very serious, may be trans- 
ferred by means of shaving brushes, towels, and razors. 
It is very important, therefore, for every community 




Fig. 100. — Note the absence of any dust-removing device 
for the protection of the workman in chairmaking 

to have close supervision over barber shops. The 
work of the Department of Health of New Haven, 
Conn., may be taken as an instance of what can be 
done by a community without formal laws to establish 
a standard., An officer of the Department is detailed 
from Nov. 1st to March 1st to inspect the shops. By 
persistent and insistent follow up work that city has 



COMMUNITY CONTROL OF DISEASE 245 

been able to induce the poorer shops to make improve- 
ments, thus compelling the better shops, if they wish 
to shine by comparison to improve their conditions. 
The inspector, when he first begins the work, makes a 
score of all the shops. This he does again, about the 
holidays, and the last time, in February. The last 
scoring is published. This gives the barber the advan- 
tage of showing to the public any improvements he has 
made between the first and last scoring. As a result of 
this work the barber shops of New Haven compare 
favorably with those of any city and the results have 
been accomplished without legal prosecution. 



CHAPTER XVIII 
INDUSTRIAL HYGIENE 

134. Introduction. Until 1904, when the Massa- 
chusetts Legislature made an investigation into work- 
ing conditions in factories, workshops and mercantile 
establishments, very little attention had been paid to 
the subject of occupational diseases. Employers had 
almost entirely neglected matters of ventilation, light- 
ing or toilet facilities. What little resistance there was 
to these unsatisfactory conditions came from the labor 
unions. The voice of the individual was largely inef- 
fectual, because the rights of labor had not been well 
recognized and a critical workman was easily replaced. 
The worker has, except in a few fortunate exceptions, 
been exploited to the utmost. He has worked at gran- 
ite cutting or wood turning, where no effort was made 
to prevent the breathing of the dust; he has worked in 
sweat shops, where there has been almost no effort 
made to provide air or light ; and he has worked in 
factories, where he has slowly died because no effort 
was made to carry off the poisonous fumes of phos- 
phorus or lead. It has been estimated that 30,000 
wage earners are killed by accident each year and over 
500,000 seriously injured. One careful investigation 
showed that about half of the total of 410 fatal acci- 

246 



INDUSTRIAL HYGIENE 



247 



dents were caused by carelessness on the part of the 
employer. 

135. Common occupational diseases. Among these 
may be mentioned tuberculosis, which is associated with 
dusty trades ; rheumatism, associated with working in 
damp buildings; lead poisoning, common among 




Fig. 101. — Employees combing out small pieces of broom 
corn which gives rise to much seed and dust 

workers with lead; phosphorus poisoning, with match 
workers ; caisson disease, with those who build our 
tunnels under rivers, etc. ; arsenic poisoning, that comes 
to milliners and others working with dyes containing 
this chemical ; and wood alcohol, which is used to dis- 
solve dyes and which when taken by mouth, usually 
produces blindness. 



248 



HEALTH AND EFFICIENCY 



Lead poisoning may occur among workers in lead 
smelters, paint and varnish factories, plumbers, type 
makers, workers in rubber works, file cutters, workers 
in china, pottery, or earthenware; it occurs also in 
glass cutters, makers of artificial flowers, in automobile 
factories, and workers in dye houses and printing es- 
tablishments. 




Fig. 102. — Employee exposed to the fumes of dilute 
solutions of cyanide of potassium and acids in the 
jewelry industry 

Arsenic poisoning occurs in places where arsenic is 
used to make the coloring matter for wall paper or 
millinery or artificial flowers; it occurs also among 
the makers of glazed paper or the handlers of Paris 
Green. 



INDUSTRIAL HYGIENE 



249 



Mercury poisoning occurs among those who make 
thermometers, mirrors, felt hats, etc. 

136. A study of occupations. In order to get con- 
crete information on the subject, ask the workers in 
your family to tell you what sources of disease or dan- 




Fig. 103. — A workman treating felt cones for hats with 
shellac and wood alcohol. The removal of poisonous 
fumes is not satisfactory 

ger, if any, are present in their working places and 
ask them further what steps might be taken to correct 
the conditions. As soon as these records have been 
obtained, make a list of the occupations on the black- 
board and opposite each one, note the sources of danger 
and what constructive work might be done to remedy 
the condition. Appoint a committee of the class to go 



250 



HEALTH AND EFFICIENCY 




Fig. 104. — A workman in the lead industry wearing a 
respirator while working with red oxide of lead 
.and litharge 

to the local board of health to ascertain what investiga- 
tions or campaigns it has carried out to improve the 



INDUSTRIAL HYGIENE 



251 




Fig. 105. — Heel scouring in the boot and shoe industry. 
This shows ineffective draft for removing dust 

sanitary condition of the workers. If your class rec- 
ords show where improvement is needed, give the in- 
formation to the proper health authority. 



252 HEALTH AND EFFICIENCY 

137. What can be done to improve conditions. 

(a) Education. It is of the greatest importance that 
high school boys and girls should know the dangers 
to health associated with certain special diseases like 
the manufacture of matches, making of dyes, and lead 
working. It is of the greatest importance also that 
workers should organize, through their unions, etc., 
campaigns to compel employers to remedy bad condi- 
tions. Thus education is fundamental to an improve- 
ment of industrial sanitation, (b) Investigations. 
These can be well carried out by the State or by edu- 
cational institutions. If one has never been attempted 
in your district, endeavor to interest an organization to 
attempt it. If investigations have been carried out, ob- 
tain reports of them for the purpose of class discussion. 

(c) Laws. Education is limited in what it can do since 
many employers can be reached only by the M strong 
arm of the law." Laws bearing on industrial hygiene 
should be based on careful scientific studies, but should, 
when established, carry with them a penalty, as they 
are otherwise ineffective. Laws of this sort may per- 
tain to the hours of occupation, child labor, employ- 
ment of women, rest periods, recreation quarters, etc. 

(d) Inspections. These are necessary to make sure that 
the laws are being carried out. Find out when an 
elevator, buildings, or dairy inspector made his last visit 
to your neighborhood and later make note of his next 
visit. 

138. The mistake of the employer. When a shoe 
manufacturer wishes to buy a new machine, he first 
looks over the market with an eye to selecting that 



INDUSTRIAL HYGIENE 



253 



machine which will do best the work which he has in 
mind. He takes into account its cost and its efficiency. 
When it is installed, he cleans and oils it. When it 
gets out of order, he repairs it. But how different 
when he selects his human machine — there is no ques- 
tion as to physical health (how long the machine will 





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Fig. 106. — Effective dust removal system in Boot and 
Shoe Industry 

last) or care to select the individual best fitted to per- 
form the task, or attempt at readjustment if an individ- 
ual fails at one task, or attempt to ascertain why this 
worker cannot get along with oth.er workers, or why 
that one is " out " so much, or why another is given to 
intoxication. In a pamphlet prepared by the Bureau 



254 



HEALTH AND EFFICIENCY 



of Public Health Education, N. Y. City, and called 
" First Aid to the Industrial Worker," the author 
lays down the following suggestions which, if practised 
would, he believes, greatly improve human industrial 
efficiency : 

" i. Applicants for employment must be studied, ex- 
amined, tested, and taught. 




Fig. 107. — Bad bakery conditions. (On a main street in 
one of our large cities.) 

" 2. Applicants must be sorted to the task which 
physical construction and mental alertness sug- 
gests is most fitting. 

" 3. Workers must be supervised, not only to detect 
loafing or vicious habits, but also to see that 



INDUSTRIAL HYGIENE 



255 



they are efficient and that the labor is not in any 
manner causing wear or maladjustment of the 
human machine's parts. 

The same effort that is made to prevent waste 
of energy, in a machine, must be given to the 
laborer. When lost motion, friction, waste of 




Fig. 108. — Model bakery conditions. 

energy, or wear is indicated by evidences of 
physical defect or approaching disease, an im- 
mediate overhauling of the worker is demanded. 
This is done in the case of the expensive, com- 
plex, and delicate machine; why not with the 
workman who is an incomparable adjunct to the 
shop?" 



256 



HEALTH AND EFFICIENCY 




The photographs illustrating good and bad sanitary conditions in various 
industries were kindly loaned by the Mass. State Board of Health 

Fig. 109. — One protective hood out of position, being 
wrongly used by the workman for holding wax 

The author goes on to say: " If such were done, even 
only partly so, then there would not only be much less 



INDUSTRIAL HYGIENE 257 

labor turn over, less loss of valuable raw products, less 
loss of time, but an appreciable reduction in human 
sickness and misery, a great increase in production, 
with a consequent helpfulness to all." 

139. Health examinations and insurance. The 
worker in the factory goes over his machine regularly, 
cleaning it and noting any loosening or straining but he 
rarely thinks of his own machine which cannot be du- 
plicated and which can be built up only with difficulty 
when it breaks down. Modern medicine can do a great 
deal in the way of prevention of disease and in the 
sparing of weakened organs if sufficient notice is had. 
The only way to find out if the heart is pumping the 
blood as it should or the kidney excreting waste is by 
a thorough examination by a competent licensed phy- 
sician. The best experience shows that such an exam- 
ination should be made at least once a year. In spite 
of the best of care, however, accidents and epidemics 
occur and the hand or brain of the worker may be 
stilled in an instant. It is therefore only prudent that 
some measure be taken to care for one's family in such 
an event. This can best be done by Accident or Life 
Insurance. Before taking out a policy consult persons 
who have had experience with the different companies 
and read the prospectuses, etc. 

140. Child labor. In a democratic commonwealth, 
education sufficient to enable each member to be an in- 
telligent participator in the affairs of the government 
is a fundamental necessity. It is now regarded as es- 
sential that the minimum requirement in this respect 
should be the completion of the grammar school course. 



258 



HEALTH AND EFFICIENCY 



In addition, it is essential that the worker be in sound 
physical health and that he should not be below a cer- 
tain age. If it becomes necessary for a boy or girl to 
leave school when he is old enough to obtain a workings 
certificate an opportunity for continuation of schooling; 




Fig. 



Copyright by Underwood & Underwood 

II0 . — Dr. Noguchi of the Rockefeller Institute for 
Medical Research. Dr. Noguchi has made several 
important discoveries in the field of infectious 
diseases 



should be offered by means of Continuation Schools. 
In one city the administration of the laws relating 
to the employment of children between the ages of 14 
and 16 is in the hands of four agencies. This pro- 



INDUSTRIAL HYGIENE 259 

tects children from being exploited at the expense of 
their bodies and souls. These agencies are: 

i. The State Department of Education. 

2.. The City Department of Education. 

3. The State Industrial Commission (the Depart- 
ment of Labor). 

4. The local Board of Health. 

To obtain an employment certificate it is necessary for 
the pupil to present: 

(1) The School Record. 

(2) The Physical Examination Record. 

(3) The Employment Certificate Blank. 

The forms in all three of these cases must first be ap- 
proved by the Department of Labor. 



INDEX 



Adenoids, 116, 118 
Air, 57 
Air sacs, 13 
Alcohol, 129 
Amoeba, 20 
Anthrax, 20 
Antiseptic, 31 
Antitoxin, 33 f 35 
Appendix, 9 
Athletics, 52 
Augustine, 4 
Auricle, 11 

Barber shops, 245 
Bathing, 136 
Bathrooms, 189 
Bedbug, 236 
Beri-beri, 89 
Bile, 122 
Biliousness, 123 
Blood, 125, 127 
Boils, 138 
Bologna, 4 
Bones, 7 
Brain, 14, 155 
Breathing, 58 
Bronchi, 13 
Bruises, 133, 170 
Bunions, 139 
Burns, 168 

Calcutta, 70 
Callous, 139 
Camp, Walter, 54 
Canker, 134 
Carriers, 28 
Cells, 22 

Cigarette smoking, 129 
Circulation, 12 



Clothing, 140 
Concentration, 165 
Convulsions, 174 
Corrective exercises, 49 
Cowpox, 32 
Cuts, treatment, 133 

Dental charts, 113 
Dental examinations, 113 
Digestion, 120 
Digestive canal, 9 
Diphtheria, 34 
Disease, 16 
Dislocations, 170 
Drinking fountains, 182 
Drowning, 169 
Ductless glands, 126 

Ear, 152 

Economic aspect, 105 
Engine, 72 
Epidemic, 20 
Epilepsy, 158 
Eruptions of skin, 137 
Eye, 145 

Fainting, 172 
Fat, S3 
Fears, 158 
Fires, 168 
Flat feet, 48 
Flea, 227 
Fly, 230 
Fractures, 170 
Frostbite, 172 

Garbage, 191 
Germs, 18, 30, 31 
Germ garden, 109 



260 



INDEX 



261 



Germicide, 30, 32 
Goitre, 126 

Habits, 162 
Hair, 138 
Headache, 157 
Heart, 9, 59, 127 
Hemispheres, 14 
Hemoglobin, 86 
Homebuilding, 185 
Hookworm, 228 
Hydrophobia, 18 

Idiosyncracy, 94 
Immunity, 36, 27 
Immunization, 241 
Industrial hygiene, 247 
Infectious diseases, 240 
Influenza, 26 
Intestines, 9 
Iron, 86 

Isolation hospitals, 244 
Ivy poisoning, 173 

James, William, 44 
Janitor service, 183 
Jenner, 32 

Koch, 22 

Laundry, 193 

Leucocytes, 30 

Lice, 227 

Life Extension Institute, 75 

Lister, 23 

Liver, 9 

Lunch rooms, 183 

Lungs, 13, 59 

Mental hygiene, 155, 157 
Microbes, 19 
Milk supply, 199 
Minerals, 81 
Mosquito, 238 



Nails, finger, 139 
Nerves, 15, 158 
Nervousness, 158 
Neurous, 162 
Nose, 116 
Nosebleed, 174 
Nucleus, 23 
Nutrient, 80 

Occupational diseases, 248 
Overweight, 91 

Pancreas, 9 
Panics, 168 
Pasteur, 4, 16, 27 
Pasteurization, 205 
Pellagra, 89 
Personal dietaries, 97 
Perspiration, 135 
Plumbing, 189 
Pneumonia, 68 
Poisoning, 172 
Posture, 39 
Protein, 80 
Protoplasm, 22, 80 
Pulse, 133 

Reflex action, 160 
Regulating substances, 84 
Regularity of meals, 94 

Sanitaria, 244 
Scalds, 168 
Senses, five, 145 
Scurvy, 89 
School hygiene, 179 
Serum, 34 
Sewage, 222 
Sickroom, 193 
Skeleton, 6 
Small intestine, 122 
Smallpox, 23 
Snelling chart, 152 
Sour milk, 20 
Speech defects, 119 



262 



INDEX 



Spinal cord, 15, 155 
Sprains, 170 
Stomach, 9, 120 
Sugar, 78 
Sunstroke, 174 

Teeth, in 
Temperance, 92 
Tonsils, 118 
Tourniquet, 172 
Toxins, 28 
Trachea, 13, 119 
Trichina, 226 
Trudeau, 67 
Tuberculin, 203 
Tuberculosis, 20, 25, 64 



Underweight, 91 
Utilization of scraps, 107 

Vaccine, 34, 37 
Vaccination, 32 
Vegetables, 87 
Ventilation, 68 
Ventricle, n 
Vertebra, 6 
Villus, 125 
Virus, 33 
Vitamines, 89 
Vocal cords, 119 

Warts, 139 
Wastes, 222 
Worms, 226 



